Saturday, July 2, 2011

New Rheumatologist

The guy's name is Michael Mericic and he's supposed to be a rheumatologist who specializes in diseases of the bone in rheumatology...he even had a lovely book displayed in his exam room which he wrote. Overall I liked him. He's nice and he seems to know what he's talking about. He actually kinda reminds me of the hematologist, which is a good thing. Here's a breakdown of what he said:

  • There doesn't seem to be any clear reason why my bones aren't as strong as normal. He asked about my past steroid use and besides being the hospital I've never taken more than 20 mg at a time for about 3 weeks at a time...so that would not cause it. Also, the steroids used in the hospital wouldn't show any damage for years to come, if at all.
  • The CT of my hips shows white (bone is supposed to be gray) on both femoral heads and about a 4 inch section at the top of both femurs. That could either mean there's fluid in the bone, the bone is dead, or it was damaged at that point but has repaired itself.
  • The CT of my hips (which was done prior to being bucked off the horse) also showed that my L4 vertebrae had a compression fracture. Weird seeing as the scans of my entire spine while I was in the hospital in Dec were completely normal except for a vertebrae in my neck. So what happened between Dec and April to my back?
  • He ordered blood work to see how my body is absorbing vitamin D and a repeat hip xray.
  • They don't give bone medications (like fosomax or boniva etc) to women who are pre-menopausal. I didn't catch why, but seemed like some hormonal thing.
  • He didn't want to check my estrogen levels (even though I mentioned it about 3 times) because it fluctuates throughout the month and since my body doesn't show any signs of a hormonal imbalance, there's no reason to think my estrogen level isn't normal.
  • He also does not like Benlysta. Or rather says there's no reason to like it yet. Basically, he said the studies showed that most of the time there is no or minimal improvement and since they don't know the long term effects, it wouldn't be worth it to risk taking it. Also he said it's about $35,000/year.
  • He doesn't like the idea of kyphoplasty. Basically that was because the blind studies showed the same improvement with the procedure and the sham procedure. That just goes to show how much power your mind has over your body.
  • He'll let me know about the blood work and xray and figure out what step to take next.

1 comment:

JoAnn Nehs said...

Thanks so much for the post. Very informative. At least is sounds like he knows what he is doing. So lets hope and pray the the results of the tests turn out to be good. And that he can figure out a course of action to prevent any more damage to the rest of the bones and to fix the parts that are already dead. Did you ask him if it might be the Lupus that is attacking the bones and what to do about that if that is the case. Hope you get to follow up with him as long as you need to.
I will take the third senerio , "that it was damaged at that point but has repaired itself.") Or a complete miracle would even be better. the xray shows all the damage is gone. At this point any encouragement is welcome. Hang in there Lea,with God's help you will get through this.