The Good, The Bleh, and the Waiting Game

Last Friday, I posted about my trip to an orthopedic specialist who decided that I need elbow surgery.  Since he did not feel qualified to work on my elbow, he referred me to a Dr. G, who I went to see yesterday. 

Here's the GOOD that came out of that appointment:
 Dr. G is a wonderful doctor.  He's very intelligent, patient, and took the time to talk with me and explain things thoroughly.  He also took his own X-rays (something that every good orthopedic specialist will do), and even X-rayed my right wrist when I mentioned that it was painful.  Now, I knew that wrist was in bad shape--after all, it looked like Swiss cheese at my last MRI.  But even Dr. G was surprised with the amount of damage.  He asked if it was just left over from my RA-onset four years ago.  I explained that no, it wasn't this bad to begin with, nor was my elbow, but that my disease is still progressing.  Always a fun thing to admit when my main coping mechanism is to treat it as an inconvenience and pretend that the pain DOES NOT mean physical joint degeneration.  Oh well.  After that conversation, Dr. G explained that my wrist joint has actually shifted right 3 millimeters and that the bottom joint on my right index finger is acutally thinner than the others.  The good news is that, even though my wrist is collapsing, it's collapsing more-or-less straight down.  THAT means that, hopefully, my wrist won't deform.  Which would be nice lol.

The other good news is that Dr. G has decided to try cortisone injections before jumping straight into surgery.  Bryan was impressed with that because, in his experience, "cutters normally like to cut."  Dr. G is hoping these injections will work for 6 months.  That would be very nice, but I will be incredibly impressed if they work for 1--that would be longer than any cortisone injection has lasted in this wrist and elbow for the past four years.

Now, on to the BLEH:
Yes, I need surgery.  As Dr. G put it, even if God came down tomorrow and took all the RA away (which isn't going to happen), the mechanical damage would still be there and need to be addressed.  If I were 50-55, he wouldn't even hesitate on scheduling the surgery.  However, I am 25.  The wrist fusion wouldn't be all that big a deal, even at my age, but the elbow replacement would be a huge deal--it would be 2-3 months before I could move my arm again, the weight restriction on the prosthesis is no more than 5 pounds, AND the prosthesis, at best, is only made to last 10 years.  And a secondary elbow replacement never goes as well as the first one.  And I WILL need these surgeries, but there is a bit of good news.

Dr. G said I could put them off as long as I could stand to!  Those of you who know me know that he probably should NOT have told me THAT--procrastination is my specialty!  Of course, with the bone-on-bone situation in my elbow, eventually I'll probably start getting bone spurs, and at that point surgery won't be an option, it will be a necessity.  BUT I can sure try to put it off until that point!  My personal ideal would be to wait until after we've had a kid and that kiddo has grown up enough to not need to be picked up.  Of course, at that point, we're talking quite a few years, but again, I am STUBBORN and a professional procrastinator!

More BLEH:
Dr. G decided that I need to wear a wrist brace ALL THE TIME except when watching TV and taking a shower.  He's hoping that the brace will reduce the mechanical stress on my right wrist.  Last night I wore it to sleep like a good little patient and winded up clocking myself in the face with it lol.  Another plus is that, once I get used to it, I will have a pretty good idea of what not bending my wrist will be like after it gets fused, whenever that might be.  I need to think up a name for my brace, since hopefully we'll be together for awhile!

Also, Dr. G has put me on restriction, just as if I had already had the surgery.  Except he's being stricter.  His hope is that by restricting mechanical stress on my right elbow, we can put off the surgery even longer.  So, my restriction is that I can not lift any more than 2 to 3 pounds with my right arm.

I am trying to, as my loving husband says, "swallow my pride" and submit to the wrist brace and weight restrictions and be a good little patient.

Which brings us to THE WAITING GAME:
I'll go back to see Dr. G in a month.  At that point, if the cortisone is still working (cross fingers!) and the restrictions have helped, I probably won't go back until time for my next injection.  If the cortisone works like it normally does, hopefully the restrictions will help.  Still, at that point, we'll have to talk about our next options.  Luckily, I will see Dr. C before then for my August infusion, and we'll be able to discuss Dr. G's findings and I'll get his take in regards to the RA.

So, that brings us up to speed on the whole RA thing!  It's only been four years (well, four in August) since I was diagnosed, and I sure didn't expect it to get this bad this quickly.  I thought that I wouldn't be on an IV treatment (Remicade) until I was in my 30s, and that joint replacement wouldn't even enter the conversation until a good while after that.  But as my wonderful and infinitely supportive husband has said, I have to play the hand I was dealt, adjust accordingly, and, as I always have, NOT let this thing control me or my life.  Still, think good thoughts for me folks, I could sure use them!  Thanks in advance!