4/18/24

Thursday, April 18, 2024

Big Birthday 

Lights out before 10, one pit stop, then another ps about 2 a.m., much pain, muscle (?) joint?.  Stayed awake, tried to sleep again at 3:30, another ps and lights on at 5:20.  At some point I dozed off again, sitting straight up, and woke up when Geri came in at 7:30.

Pain. etc.

Dear Dr. Chatt:

Re: my upcoming appointment on 4/24/24

I am sending this message out of a concern that, for one reason or another, I may not be as thorough or coherent at the appointment as I can be in this message.

My overriding health concern now, and for the past many weeks, has been chronic pain that has profoundly affected my daily life.  My current understanding is that (1) the pain is the result of osteoarthritis, (2) the painful condition is not to be expected to get better, but rather may be expected to get worse with age, and (3) the best treatment is OTC analgesic topical cream, Tylenol, and physical therapy.  (I had a cortisone injection from Dr. Cheng in PM&R on   --- which provided no significant pain relief.) 

What I would like to discover is whether my painful conditions may be attributable to something other than osteoarthritis, like rheumatoid arthritis or polymyalgia rheumatica, or something else, i.e., some condition that may be treatable with something more effective than OTC medications and physical therapy that haven’t been very effective for me.  IF not, I understand that I may expect the chronic pain to continue for the rest of my life.

The reasons I am wondering about these matters are:

1. The cortisone injection on ---- had no noticeable effect on my left shoulder pain.

2. The left shoulder pain has been with me since 12/25/2023.

3. Some time after 12/25/2023, my right shoulder also developed the same kind of pain.

4. On 1/13.2024, I developed significant pain in my right wrist and hand which has only gotten worse over time and results in considerable swelling of the hand.

5. Some time after 1/13/2024, I developed pain in my left wrist and hand.

6. I have also developed pain in both hips which I experience when standing up and which does improve with walking.

7. I also have pain and stiffness in my lower back when engaged in ordinary household activity, which can be pretty crippling, requiring me sit down, for example, in the middle of loading the dishwasher or other chores.

8. I also have some pain and stiffness in my neck.

I add that the shoulders pain and hands and wrists pains are decidedly more severe at night and in the mornings than in the afternoons and early evening.

I’ve been sleeping on a recliner chair rather than in bed for the last month because of the shoulder pain and difficulty getting up from the bed and out from under bedding.  For more than a month, the chronic pains (in addition to chronic bladder conditions) have made it impossible to get sufficient rest at night.

For several years now I have worn compression socks because of a chronic lymphedema condition. Because of the hand/wrist and shoulder pain, I haven’t been able to get those socks on and off for some time and the swelling in my feet, ankles, and lower legs has become substantial.  The added weight of the fluids in my lower legs makes lifting my legs challenging.

These conditions and challenges have arisen over the last 4 months and they have turned my life upside down.  When I am hoping to know is whether they are simply the result of age-related, wear-and-tear osteoarthritis treatable with OTC NSAIDS and physical therapy, or whether some other factor is causative.  Ultimately, I’m wondering whether this is what the rest of my life will look like.

Thank you.

Mean Streets.  I watched it again this afternoon.  Harvey Keitel's role is so interesting.  Robert DeNiro's is so contemptible.  It's hard to believe it was filmed mostly in Los Angeles rather than Little Italy.  The San Genaro Festival scenes however were filmed at the festival and reminded me of the time, many years ago, when I attended it.

Birthday Dinner.  We shared a Cobb Salad from Crave.