Rheumatoid Arthritis and my great GP who will deal with my laundry list of problems

I went and saw my friendly neighborhood GP this morning, with my usual laundry list of current issues.  He doesn’t mind me bringing in more than one problem.  He knows we can generally talk through my list quickly and efficiently.

My list included a request for more valium.  He’s comfortable with prescribing 20 tablets per month.  He understands that I have Premenstrual Syndrome (PMS) which is technically a symptom of Polycystic Ovarian Syndrome (PCOS).  Given that I lead an inherently stressful life with severe daily chronic pain and disability, a son with Asperger’s Syndrome and anxiety, a daughter with anxiety and that I am a single parent and their sole source of support he understands that the stress builds on me somewhat.  And when I am hormonal for those few days a month, some valium allows me to remain calm and deal with the current crisis rather than wanting to curl up in the corner and cry.  It also and helps me sleep.  Yes, it would be better if I could employ other methods of stress reduction – soak in the bath, have a massage, meditate, go for a run, eat chocolate…but none of these options are doable for me anymore.  So for me, quick, effective stress relief is obtained with a little white tablet.  And for me, it’s a great drug, and he’s a great doctor for recognizing that I can take Valium for a few days a month, receive very good benefit with no side effects, then put it away again.  No addiction issues.  So he wrote me a script.

It helps that I am very open about my use, when and how, and how many I take. And that he knows I understand the interplay between benzodiazepines and opioids.  Acceptable risk.

I also asked for a referral back to my pain management doctor. Yes, the one I can’t stand.  Given that Xeljanz and fasting have lowered my inflammation levels, the pain I’m feeling now is from damage done, not inflammation.  The places where I feel the most severe, daily pain are my sacroiliac (SI) joints, my hips, my knees and my shoulders, right worse than left.  Given that I had a successful radiofrequency ablation on my SI joints two years ago, it’s time to schedule another.

And last but not least, it’s time to address my shoulder.  I have ‘snapping scapula’ or scapulothoracic bursitis.  It’s been on the backburner for years, and given that I have had physiotherapy, previous surgery on this shoulder that didn’t address this particular pain (I was hoping it would), my gallbladder removed that didn’t address this particular pain (doctors told me it would), and this pain has been there for at least four years, every day, constantly, and it’s not mild pain, it’s time to do something about it.

I discovered what the problem was by googling. Yes, did that most abhorrent thing, I self-diagnosed. Then I lied about it and told my doctor that my physiotherapist had diagnosed the problem. Little white lie, often necessary to quickly achieve the desired outcome.   Scapulothoracic bursitis, or snapping scapula, is very rare, so my GP hadn’t heard of it.  But he looked it up in his magic book and then completely agreed with the diagnosis. He referred me for a cortisone shot, the next line of treatment when physiotherapy has failed.

I don’t do any weighted overhead work with this shoulder, ever. I haven’t since my subacromial decompression surgery, on advice of my surgeon.  But these days I don’t even want to lift this shoulder, and holding a plank position is very painful, so hopefully the cortisone shot will help, and then I can look at a more permanent solution.  If the cortisone shot helps, I can have surgery to remove the chronically inflamed bursa, which has excellent long term outcomes.  But we’ll see. One step at a time.  Right now, just a little pain relief would be great.

Chasing pain.  Or rather, chasing pain relief.  It’s kinda what I do.  I know it makes me look like a hypochondriac, but my behavior is also consistent with an intelligent, educated person trying to find pain relief.

I know which one I am. Luckily my GP does as well.