Taking Time Off From Alcohol-Consumption (Due to a Medicine)

Having been diagnosed with rheumatoid arthritis, the rheumatologist who has been treating me has tried different medicines on me, with the most recent addition to my medicine being one that, unfortunately, is not good for my liver. Because it is not good for my liver, I am supposed to severely restrict my alcohol intake. When the rheumatologist first mentioned an alcohol intake restriction and began by saying "3-4 drinks...", I thought "He's not going to say 'a day', but maybe it'll be down to just 3-4 drinks per week (which is something I can figure out to manage)", then he concluded by saying "...a month." That was quite a shock!

So now, I am limited to just 3-4 drinks a month, lest my liver suffer more, due to this new medicine.

Therefore, I won't be drinking much these days.... That isn't to say that alcohol is entirely out of my life, but I restrict my consumption to about a drink on Friday evenings (usually, some sips of a variety of beers). Although I may make exceptions and sip some beer here and there if need be, alcohol is otherwise out of my life.

That also means I will not be getting drunk or even buzzed these days. Fortunately, I made sure to have one last hurrah a few days before beginning the medicine a couple of weeks ago, sharing plenty of beer with a drinking buddy, and getting pleasantly drunk. That will be the last time I get drunk for the foreseeable future....

While it is a gamble to take off from alcohol consumption for a few months just to see if this new medicine works (the effects are not expected to be take place for 10-12 weeks), I'm looking on the bright side: it's a significant decrease in my caloric intake. I am hoping, if nothing else works, that at least I should, hopefully, lose some weight by [mostly] cutting out alcohol from my life.

Let's see how this goes....
 

The Treatment of My Rheumatoid Arthritis Begins

When I was told by the rheumatologist [the first time I met him] that I had rheumatoid arthritis, it was quite shocking - not only surprising, but shocking, as well. Of course, I knew there was something wrong with my body, but I thought it was something of a temporary nature, not something that would continue to afflict me throughout the remainder of my life. It still is hard for me to wrap to head around the enduringness of this condition – I still, on some level in my head, think that it’s temporary (even if I’ve been told that it’s not).

While I was still in shock about my new diagnosis, the rheumatologist began discussing treatment options.

Mostly, the treatment options concerned taking pills, which are no problem for me. He also mentioned a shot, which gave me pause. 

A few days following the visit, I did take him up on getting the shot. It was a steroid shot, which, the following day, I already felt the results. It had, overnight, decreased the swelling in my feet and hands. That was fast! I was very glad to have, for the first time in months, not have swollen hands nor swollen feet. I was excited that it not only worked, but had worked quickly, as well as relieved about the swollenness. While I also was concerned that I might need to have the shot again because maybe the swelling would return, to this day, the swelling hasn’t returned (at least not to the degree that it had been before that shot).

There were three pills that he had prescribed. One was a painkiller that would take the place of any others (e.g. ibuprofen, acetaminophen, etc.) should I need a painkiller or to reduce swelling. While I took it regularly at first, I now seldom use it. But there were two other pills I took that were meant to deal with the condition.

One pill was meant to block the signals causing the inflammation,* to be taken regularly. I’m not sure if it has helped or not, even to this day. Nevertheless, I still take it, because it may be working – it’s hard to tell, since the other pill had noticeably positive effects.

The other pill worked considerably well!** Wow – right from the start it worked well and continued to work. Unfortunately, it seems to be a short-term solution to this long-term problem. Nevertheless, it significantly decreased the tenderness I experienced in the parts of my body where I noticed the greatest amount of tenderness (i.e. hands/fingers/wrists, feet, knees, shoulders, and elbows). Not only did it greatly help me do everyday things (e.g. picking things up, moving things around (including my kids)), but I noticed it the most while weight-lifting. It definitely helped my body (particularly my shoulders and elbows) move and use strength. It also helped with energy, as it was quite an energy boost – very noticeably physically, but also mentally, as well (it also gave me a self-confidence boost, as well). Of course, it was great when going to the gym, as I had an energy boost, but also just doing things throughout the day. It was definitely something to be taken in the morning and not later on in the day.***

Unfortunately, my rheumatologist told me to only take smaller doses of this latter pill, resulting in an increase in tenderness in my joints. As of last month, I have decided to take a break from weight-lifting, since my ability had been greatly diminished from when I had been taking higher doses of this medicine. Although I kind of miss having weight-lifting as both part of my lifestyle and routine, as well as its effects on my body, I also can’t ignore that my bodily abilities to lift weights in any realm of my life have been severely reduced.

The latest news in my treatment, however, have been saddening. Since the other pill* didn’t seem to be working enough (although we’re still keeping it as part of the treatment on my body), the rheumatologist has added a new pill. The pill, itself, seems to be fine (although I’ve only taken it twice, as its dosage is weekly),**** but it’s not so great for various aspects of my body. The most concerning of these is that it’s not good for the liver. Thus, a severe restriction on alcohol intake :( So, while alcohol is generally not permitted for those taking methotrexate, the rheumatologist says it’s alright if I have 3-4 drinks a month.  Yikes! In any event, I’ve barely sipped alcohol in the last couple of weeks on account of this new medicine. (I hope to write more in the future about this severe reduction on my alcohol intake….)

Anyways, that is what is going on in treating my new condition.

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* If you’re interested, it is hydroxychloroquine.

** If you’re curious, it’s prednisone.

*** When I picked it up from the pharmacy, I was told by the pharmacist not to take it after 9am – “9:00 AM?” I asked, to which she replied that some patients have had trouble sleeping when taking it later in the day. I initially brushed off the warning and took it right away, since I wanted to have the pills start working, even though it was in the middle of a Friday afternoon. Wow – was I bouncing off the walls that night! I couldn’t fall asleep until 4am (and, yes, that included a lot of alcohol, which had little effect on my drowsiness). I then made sure I took it early in the morning and definitely did not take it in the afternoon.

**** Again, if you’re curious, it’s methotrexate.

The Troubles Begin

So, apparently, I have a couple of health issues...and here's what's been going on.

Back in March of last year, I saw my doctor since my wife had suggested that I might have sleep apnea, so my doctor referred me to Kaiser Permanente's sleep clinic. After going to the earliest opening they had a half year later in September, they said I most certainly do have sleep apnea. After the doctor then said that, if untreated, a slew of bad health problems could follow; thus, we should treat it using a CPAP machine. 

So, I bought a CPAP machine in October and started using it by the end of the month. While I tried using it, especially in earnest at the outset, it never seemed to actually me sleep nor feel well-rested. The only thing with which the CPAP machine has helped me is serving as an aid in falling asleep. I find that not only does it, in some way, seem to hinder my breathing, but that there is also some uncomfortability on my face with the mask.

Separately, I noticed within a week or two of using the CPAP machine that my fingers would no longer straighten all the way. Additionally, there was some pain in a couple of them. Furthermore, there was some swelling in my fingers, as well as, more noticeably, my hands.

At first, I thought what was happening to my hands and fingers was because I laid differently when using my CPAP machine - when I would read books at night in bed, I would lean my chin on the back of my hands and, perhaps, it was that pressure on my hands that was causing the pain. I wasn't sure if that was the case or not, but that was the only change I knew in my life.

In any event, it didn't go away and my fingers remained curled, but I figured it was merely a temporary condition. Since I had some difficulty and trouble at the gym with lifting weights, I decided to stop in early December until I could figure out what was going on with my hands/fingers (I didn't know if the pressure on my fingers might be problematic with regards to weight-lifting). I then went on a trip at the end of December through the beginning of January to Israel and decided that, if my fingers continued to stay curled, I would go see a doctor about them. As it turned out, they did not get better, so I went to see the doctor in January. When I saw the doctor, I told him about what was going on with my hands/fingers and he referred me to an orthopedist.

While on the aforementioned trip, a seemingly unrelated incident happened: one day, we were in Jerusalem and walked a lot and it made the arches of my feet hurt, resulting in my feet swelling. At the time, I chalked it simply to being part of so much walking and/or the uncomfortability of my shoes, perhaps. However, the soreness in my arches and the swelling didn't go away after getting back. I had thought it would last for only a few days and then it would get better, but it never went away.

When I visited the orthopedist, I told him about both my hands/fingers as well as my feet. He wasn't really sure what was going on, so he sent me to get an MRI. After having scheduled the MRI, I then discovered it would cost over $1100 for the MRI on my hands, so I decided not to spend all that money on my hands. Having related that to my orthopedist, he then referred me to a rheumatologist.

When I went to see the rheumatologist in March of this year, he told me, after seeing my  blood draw results, that I have rheumatoid arthritis. It took me a moment to try to process it. I had heard of the condition from commercials that I ignored. I was shocked about this, but also totally naïve about it. I then asked about how to fix/cure it, to which he responded that there was no cure (at this point in medical research). So, I then asked about treatments, none of which seemed particularly good or short-term....

(to be continued)