A pattern emerges

Scorecard(0-10)
Legs:2 - (left knee:5)
Shoulders:2
Wrists & Thumbs:1
Ankles & Toes:0

Just back in from a week in Val d'Isere where I was able to ski restricted only by the fatigue associated with the sulfasalazine and my now lack of fitness. Still had some very good days on the glaciers though. Deep blue skies and perfect, light snow. Towards the resort the snow was like a pudding and was very hard work. Also, with the unseasonally high temperatures, I was severely over heating in my ski gear and this added to the sense of exhaustion.

At the end of the week I decided to find out if I still need the diclofenac drugs. I stopped taking them yesterday. And Lo! My left knee has swollen up this morning and a familiar ache has reasserted itself in my shoulders.

Now this is very similar to what developed in January after I experimented with cutting out the NSAID drug I was then using - mefenamic acid (Ponstan.)

So that now strongly suggests that all the relief I've been getting has come from the NSAIDs and the benefit of the sulfasalazine has yet to be realised.

It also makes me wonder whether there may me a mechanical explanation after all for this entire experience.

I won't have long to wait to find out. I have X-Rays on my shoulders tomorrow.

Good day today

Scorecard(0-10)
Legs:0
Shoulders:0
Wrists & Thumbs:0
Ankles & Toes:0
Nausea:0

Today I'm as twinge free as I've been for a while. Even the left knee has loosened up and I'm now happily looking forward to skiing on it next week.

Yesterday I climbed up to the full dose of sulfasalazine, now on 2Mgms daily. I doubt that is already responsible for today's happy condition but I'm not complaining. I'm still taking the diclofenac at the moment, I'm not intending to stop that before the end of next week's skiing.

I had blood tests yesterday to see what, if any, damage the sulfasalazine has done. Hopefully none, I would prefer not to have to start a different course of drugs now with the regression that would involve, at least temporarily.

I seem to have found a way to prevent the nausea setting in too. If I wolf a large meal I pretty quickly feel queasy with it. However, if I eat a light meal slowly I seem to bypass the nausea phase. It suggests a mechanical cause for the nausea associated with my stomach expanding in response to a large meal. Maybe my liver has increased in size and things are banging into my diaphragm...

Sadly, I have to attend the funeral of Anne McHattie this morning.

Ominous

Scorecard(0-10)
Legs:2
Shoulders:0
Wrists & Thumbs:0
Ankles & Toes:0
Nausea:1

Most of me feels quite good today but I'm a bit concerned about my left knee. It's stiff, slightly sore and showing signs of swelling up. This is a bit like the original symptoms back in November and it's not a good sign for skiing next week. I've put a tubie-grip on to keep it warm and I'll rest it up today. If it's still bad tomorrow I'll try to make an emergency appointment with the physio at ARI to see if she can help drain or move some fluid off the knee.

It's most inconvenient because it means you can never plan anything - the knee can flare up without warning and without any obvious trauma.

Substitute

Scorecard(0-10)
Legs:0
Shoulders:0
Wrists & Thumbs:1
Ankles & Toes:0
Nausea:2

Today I have very little discomfort but some continuing nausea after a quite a queasy day yesterday. The queasiness does take the shine off my mood but I suppose it's the lesser of the two evils.

I'm hopeful that it will subside as my system gets used to the sulfasalazine but the dose gets stepped up to max on Wednesday so I suppose it'll get worse before it gets better.

Fatigué

Scorecard(0-10)
Legs:2
Shoulders:1
Wrists & Thumbs:3
Ankles & Toes:0

Extremely fatigued today after a late night of 9pm yesterday acting as sommelier for the wine tasting. Right wrist and thumb are decidedly achey after the "strain" of pouring the wines. Didn't drink any.

Also swam yesterday afternoon which may account for the legs being a bit twingey today. Left knee is slightly puffy, which is a bit of a worry for Val d'Isere in a week's time. Will rest it up for a couple of days.

In fact have no energy to do anything other than rest today. Can't believe how tired I feel but it seems to be a commonly reported side effect of the sulfasalazine. Can't even muster the resources to wash the car. It's going to be a longer road back that I had expected.

Fatigue is also a bit of a concern for next week's travel. I have to drive to Edinburgh, get a plane to Lyon then drive from Lyon to Val, a journey of at least three hours, and probably in the dark. If in doubt, park up.

Uncle Dick

Scorecard(0-10)
Legs:0
Shoulders:0
Wrists & Thumbs:1
Ankles & Toes:0

No new aches or pains to report today, thankfully. You get used to some minor levels of discomfort when performing routine activities. Brushing your teeth, combing your hair generates a twinge of two. I am better at reversing the car now although I still can't fully twist round in the seat the way I used to.

Unfortunately I'm still feeling a bit queasy after the morning dose of sulphur. I have a wine tasting tonight so I hope I feel a little better for it later on. I'm not actually drinking any of the wine, alas. I was asked by a client to act as sommelier for a corporate wine event. Presumably on the misguided assumption that my excessive consumption of wine conveys upon me some knowledge of it. I'll "nose" a few though, and pronounce solemnly on the colour. This fine red is very red etc.

Under control?

Scorecard(0-10)
Legs:0
Shoulders:0
Wrists & Thumbs:1
Ankles & Toes:0

Today I have very little discomfort and the only thing that's bothering me is a continuing slight queasiness after stepping up the sulfasalazeine dose from Wednesday. Hopefully my system will get used to this and the queasiness will eventually disappear. It's the lesser of two evils though. Much rather have that that the aching joints. Still hanging in there with the doclofenac.

Have blood tests next week to see what effect the new drug is having. Must remember to get a new prescription so I don't run out in France.

Clinging on to nurse for fear of something worse

Scorecard(0-10)
Legs:0
Shoulders:2
Wrists & Thumbs:2
Ankles & Toes:0

Yesterday I decided to try and reduce the diclofenac diet, missing out the mid day dose. It was what Mr Humphrey might have described as a "courageous" decision, Minister. I was duly rewarded by the closing of a hot vice around my shoulders by evening and by bed time I had already reached for the familiar bubble pack.

Sleep was again interrupted, this time at 2am, by telephone traffic from afar reacting to a local bereavement. Consequently this morning I am both a little sore and a little tired again.

Still, this is now week three of the sulfasalazine and the dose has been increased to 75% of the final level. All up I don't feel too bad, perhaps a little queasy although it might just be jet lag from the interrupted sleep.

At this rate I might think about resuming a place in the economic process after I come back from France.

Progress continues

Scorecard(0-10)
Legs:0
Shoulders:0
Wrists & Thumbs:1
Ankles & Toes:0

My sleep was somewhat interrupted by telephone calls around 11.30pm last night. This may account for feeling a little jaded this morning. Left shoulder was a bit naggy during the night if I lay on it for too long. Nothing major though.

After a shower this morning everything is working well. Hope it keeps up for Val d'Isere in ten days time!

Capricious as the wind

Scorecard(0-10)
Legs:0
Shoulders:0
Wrists & Thumbs:1
Ankles & Toes:0

Yesterday I had what I once would have regarded as a modest hike up a nearby hill with a summit of only about 1000 feet. However, this has recently become a slightly more taxing experience.

I was laden down like a beast of burden, two cameras round my neck and a rucksack on my back. I expected to be a little uncomfortable this morning.

Not a bit of it. With bewildering unpredictability I feel as well today as I have done since the onset of this little inconvenience. Enthusiasm levels for completing chores are uncharacteristically high too!

I don't know what to put this down to. The effect of the exercise or the sulfasalazine really beginning to do its stuff - we're well into week two now. At this rate I might be able to give up the diclofenac shortly. That would be handy as it's probably been boring a hole in my stomach these past few weeks and months.

Also, there's no excuse for looking like a butter ball if I'm feeling OK. Have lost rather fewer of those 8Kgs than I would have preferred. So get your ass down to the gym sunshine!

So, much to do and let's get on with doing it!

Queasy

For the first time since I started taking the sulfasalazine I feel a little queasy this morning. Perhaps it's because it's the weekend and I don't have very much to occupy me today. If I were busy I might not notice it so much.

Although I'm still taking the diclofenac I'm hopeful that this era is coming to an end soon. The expectation I've formed of the sulfasalazine is that after it has fully taken effect I should be able to resume pretty much a normal life, perhaps with the odd twinge or two. Far from being crippled by arthritis I hope to step up the gym and the pool to something approaching their previously daily levels, and I have already arranged to go back to Val d'Isere (my spiritual home!) in March.

So, no complaints from me, all in all!

Back to the future

Scorecard(0-10)
Legs:1-2
Shoulders:2-3
Wrists & Thumbs:2-3
Ankles & Toes:0

After a quiescent couple of days since increasing the sulfasalazine dose to 2 x 500Mg daily I seem to have had something of a minor relapse.

What could have caused this? Well yesterday I had a photo shoot lasting about three hours. Lots of twisting and turning, crouching and stretching, and quite a bit of trudging. All with two cameras, including the very heavy Canon 5D, strapped round my neck and a rucksack on my back. My right wrist looks a little puffy today and is mildly uncomfortable. I assume that handling the 5D is the cause. The rucksack explains the shoulders, I guess.

I'm not going to be much of a photographer if I can't lift a camera!

However, onward, ever upward. Hopefully when the sulfasalazine really gets to work I won't notice these strains any more. In the meantime continuing with diclofenac three times daily.

Sulfasalazine at one week

Scorecard(0-10)
Legs:0
Shoulders:1
Wrists & Thumbs:1
Ankles & Toes:0

Today marks the end of the first week of the sulfasalazine, albeit still supported by the diclofenac at the moment. There is a clear improvement in the symptoms compared to the era of diclofenac alone. I feel very good with little restriction in movement unless I attempt something stupidly heroic such as opening the heavy garage door one handed.

I slept as well as I have done for some time. And next week the sulfasalazine dose is increased from 500Mg daily to 1000Mg daily.

I await further developments with interest, particularly as I have confirmed another skiing trip for end March in Val d'Isere, arguably the toughest skiing area there is.

Arthritis? It's a breeze

Scorecard(0-10)
Legs:0
Shoulders:1-2
Wrists & Thumbs:2
Ankles & Toes:0

I had a slightly uncomfortable night but not so bad that I considered reaching for the co-codamol.

Anyway, I listened to a programme on the radio last night about paraplegia and that put my condition into context. I'm in the very lucky position of having drugs which easily make my symptoms manageable. Unlike the poor paraplegics who can do nothing for themselves, not even terminate a life which they understandably sometimes find intolerable.

So I'll get on with something useful and think myself lucky to have the chance.