Steroids

It's supposed to take my last steroid this morning. Actually thought about not taking it at all, so that Dr. Lorenzo would have a better view of my real state when we see him tomorrow.

I've felt pretty good the last few days, including yesterday. There was less than the usual pain when I got off the bed, and I was walking pretty normally in a short time. And this was, of course, before I took my morning pill. So almost 24 hours since I took the last one. The night before, after dinner with the bureau and Rebecca, I found myself walking relatively quickly and painlessly to the car with Rebecca. She had noticed my feet when she arrived on Monday morning and seen me walk my way in the office but probably didnt think of it that night: I gave her little reason to. (I came to dinner from Pilates, which may partly explain why I was feeling so well.)

At least once, Kat pointed out that I get off the bed and walk into the dressing room as one man and walk out as another.

The inner-ankle pain is usually more on the left, though there have been a couple of days when it was more on the right. The heel pain transfers more often, or is often about equal. But there have been times in the last few days when I step into my blue Birkenstocks and feel almost absolutely normal.

I guess the worst I felt in the past week or so was after standing a long time at a book launch last week. Mental note: no long standing. Even after that, though, I dont think my ankles swelled up as much as they have in the past. They're still swollen though, and I havent seen the bone there for months now.

Sometimes -- like just now -- Kat asks me why I'm shuffling and I realize I am without needing to. I've gotten used to shuffling. That's another mental note.

Once in a while in bed my foot still jiggles on its own. Kat says she sees it happen when I'm asleep too. Should ask the doctor about that. Also, there are still pains in my lower back especially in the morning. It takes me a while to stretch and warm up in bed.

Downhill

Halved my steroid dose midweek, as prescribed. I think I could feel the reduction the first couple of days. Last night and especially when we woke up this morning, I felt very stiff in my lower back and sides.

We got up at 10, I had a bun of three-day old muesli bread and popped my steroid pill. Then we went swimming at Rockwell. I used my fins for the first time and was happy I could finally propel myself with my legs. Then we had lunch at Pancake House then visited Pa for an hour or two at Makati Med.

We got up after Dr. & Mrs. Benitez arrived, and she said it was good to see me without a cane. (She's seen me using one a couple of months ago.) We left the room and saw Tita Nit and Tita Chery approaching. Tita Nit asked about Pa, then asked about me. I whispered I was on drugs so I felt fine. But as soon as we started walking again, I realized I was walking quite well and told Kat. She agreed. I felt very good.

After a nap, we watched a concert at Salcedo Park. We went separately. So, when I walked down the several steps in our basement parking, I had no one to show that I was touching the wall for support very lightly. When we got back, I tried it again and then dragged her out of the apartment into the fire escape to show her.

What happened? Was it because we slept till 10? Was it because the flippers flexed my ankles? Was it because the methotrexate was really kicking in?

With the good comes the silly though. After I showed Kat not once but twice that I could walk down steps, we found out we had locked ourselves in the fire escape. We had to walk down until we saw someone at a window on the ninth floor and asked her to let us in.

I have a new pain, at the very back of my ankle. But I'm not worried about it. It seems like the pain from using a muscle that hasnt been used much in a while, which I think I got from walking down steps and walking faster today.

Here's hoping.

The Philippine AS Society

Saw Dr. Lorenzo today, who interpreted the results of the blood tests I took last week. I knew that my ESR result -- 52, compared with a reference range of 0 to 15 -- was high. What I didnt know was that the ``positive'' result of my CRP test was also a bad sign, as ``positive'' often is in medical matters.

They're both inflammatory markers, meaning, as I understand it, my body is fighting something and, at 52, it's not just something in my foot.

One of the main reasons I wanted to see him so soon was to confirm that it was OK to take steroids for as long as he prescribed: one month. I had read somewhere (that's the boon and bane of the internet!) that seven days was long, and that side-effects included weight gain and (horrors!) hair loss. He said the dose he prescribed was low.

I tried to steer the conversation toward second opinions, particularly abroad, by saying there must be very few cases locally. He said there are 100 or 200 rheumatologists and each one must have at least a couple of cases. (He earlier said he had handled about 10, which isnt much experience.) I said, but there are no AS societies as there are in the US, the UK, or Singapore. He said that's true, but if I wanted to start one, he'd help me. OK, that didnt lead where I thought it would.

What really pleased Kat about this visit? The doctor wrote out and handed to me, without our asking for it, his cell phone number.