Category Archives: Nambumetone

Voltran Gel for Osteoarthritis

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Voltran gel. So, it’s not really called Voltran, but it’s close, so that’s what I’m calling it. On Wednesday, I got to meet with my Rheumy for a much anticipated appointment. Over the past two months, as you know, I’ve been off Enbrel and not visiting my Rheumy because of a Lyme’s Disease and Mono diagnosis. I was really worn down, frustrated, and stressed out when I showed up. The nurse who is always there and works with me (the same one who taught me how to use Enbrel) put her arm around me and led me back to the exam room. She asked me how I was doing and I was completely honest with her. She was so understanding and wonderful. She told me to take a deep breath and said that we’d figure it all out. My pulse was good (72 beats a minute), but my blood pressure was up. The last few times I’ve gone to the doctor it’s been elevated which is weird because usually it’s low and everyone is always telling me how wonderful it is.That’s for the next post.

So anyway, I got my long-awaited and needed direction from him; I can go back on Enbrel! This morning I took my first injection in over two months. It was funny because this time my mentality was, thank god I get to take it, rather than ugh another injection. It made it much easier. So basically the Rheumy said we’ll give the Enbrel two more months and if it doesn’t help, we will try something else. I’m hoping the Enbrel works. He also said that if I don’t feel any better next week to let him know and he’ll probably put me on a short term course of steroids. In addition, I will continue to be on Nambumetone and hopefully that  coupled with Enbrel will do the trick.

Then he turned to my knees. I had complained about them before and how it hurts to be in the car too long, they hurt when I walk, etc. He re-examined my xrays and poked and prodded the knees for a bit and said that it appears to be osteoarthritis and that my bursae are puffy and swollen (inside of the knees). He said that he could give me cortisonal injections (to which I made a face… more injections?). He smiled and said we would try a topical osteoarthris gel first. You 2g of it on the spots of pain/tenderness 4 times a day. The gel, Voltran gel, as I affectionately call it, is another NSAID (as is Nambumetone). I’m hoping the gel will work.

So that’s about where we are. I go back in a month to follow up and get blood work done again. In addition, if nothing improves by next week, I call and go on steroids. Here’s hoping I feel better next week!

Thought for the Day:

Too Tired to Think

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I. am. utterly. worn. out. I don’t know what’s gotten into me this past week or so, but I am exhausted. Absolutely exhausted. I drink coffee in the morning and then a glass or two of iced green tea, so it’s not as if I’m not getting any caffeine! And yet, I am still completely run-down. I mean, there has been a lot of excitement going on around here. We just signed a lease for our first house! I had a personal record run of 6.02 miles! I found out one of my best friends is preggers! But I’ve also been getting decent amounts of sleep. So who knows. I am still sticking with the point that I feel great while working out but awful when I’m not. But I can’t work out all day, not with a full time job and not with the life that we’ll be living over the next month or so between traveling and packing and moving and working!

Wednesday at 4:15PM I have a follow up appointment with my Rheumy. I am hoping and hoping and hoping that he tells me it’s ok to go back on Enbrel. The Nambumetone just doesn’t seem to cut it and I’ve been really sore these past few weeks.

For the first time though, I am scared that I may not be able to do it all.

Classes started today. The national workgroups that I’m leading at work start this week. Calculus still has to be completed. We need to pack up the apartment. We need to find a subletter. We need to move. I don’t know if I can do it all. I’m scared that I won’t finish Calc and I’ll get kicked out of Grad School. I’m scared that I’ll fall flat on my face while leading a workgroup. I’m scared that I’ll fall behind in class because I’ll be too tired to do the readings and take part in the discussions. I’m worried we won’t find a subletter. I’m worried we won’t have anyone to help us move. I’m stressed out and I feel like crap.

Somehow things will work out…

Sleeping in Splints

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First off, Happy Thanksgiving! I’ll write a post about Turkey Day later! Yesterday, I met with my Rheumy for a check-up on how the meds are going, how I’ve been feeling, ailments, etc. As I suspected, I had to get more blood taken to do updated tests and see if the meds are helping at all. I did not pass out and I didn’t even black out! This time the nurse put a piece of paper with some writing on the ceiling and had me try to figure out what it said. Pretty nice of her to do and it did the trick.

As you may remember, I mentioned a few posts ago that I am having more pain and tenderness and weakness in my wrists and fingers. I brought this up to my Rheumy and he did a few tests that included questions, tapping on my wrists, and then holding them face-down in a 90 degree angle (if that makes sense) and seeing what happens. I felt pain and pins and needles. His conclusion was that I was diagnosed with carpal tunnel syndrome. He prescribed me wrist splints which I’m supposed to wear whenever I am not typing. I am also to wear them when I am sleeping. They basically wrap around your thumb and wrists and velcro in the back. Pretty shnazzy… they also have metal bars in the section which runs from your wrist down your fore arm for stability. If this doesn’t help improve the pain/tingling then they can do a full nerve test as well as cortizone shots. I am hoping that the splints will do the trick!

Along with the blood tests and wrist splints, I was also told to increase my nambumetone dosages. I have been taking 500mg twice a day. I am now increased to 750mg twice a day. The Enbrel seems to be helping at least most of the time… other than the random flare ups that I have been experiencing. My Rheumy said that we should see full effects in about 3 months time so I’m hoping that it improves.

As for my swollen ankles, he said it could be a result of the AS but if it continues, it may be worth a trip back to the orthopedist who did my ankle surgery to get it checked out to make sure that everything is good to go and there aren’t any healing issues.

So, I suppose all in all not a terrible follow-up appointment. Being diagnosed with carpal tunnel is annoying and the wrist splints aren’t particularly fun, but it could always be worse and that’s what I keep reminding myself of… so I’ll stick with icing most nights (maybe increase to every night), continue wearing my wrist splints, taking my nambumetone, and injecting myself on Friday mornings. We’ll get there yet!

Tomorrow will be dedicated to term papers, presentations, and figuring out an exercise plan so I can start seriously training for my half marathon. I’ll keep a close watch on my heels and Achilles as they have been acting up and sometime waking me up at night. Always something interesting!!!

Happy Thanksgiving to EVERYONE!

 

Trials and Tribulations of Enbrel

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As you may recall, I went to my Rheumy two weeks ago on Wednesday during which appointment he prescribed me Enbrel. That day they submitted the prescription and told me that it would need to be pre-approved by my insurance before it was filled so they would let me know when that process was complete so I could pick up the prescription. A week later (this past Wednesday), I called regarding my uncontrollable itching and also asked about the medicine. They nurse said call on Friday if you still haven’t heard anything. Mind you, I’m leaving on Monday for 8 days in Denver for work so I NEED more enbrel.

On Thursday afternoon my Rheumy called me to check in. We discussed the itching and the lack of pain relief in my knees, hips, and back. He told me to take Zyrtec, Benadryl (at night), and to switch to Nambumetone rather than Meloxicam. So, he sent in those prescriptions. I then brought up the Enbrel- he told me to talk to his secretary about it to get it figure out. The woman I spoke with was very nice, however she said “it looks like you didn’t need pre-approval, just go to the CVS and ask them for the prescription. If they won’t give it to you, let us know.” Rather than showing up like a crazed drug addict, I decided to call. After putting me on hold for about 20 minutes, the pharmacist came back on and said there was never a prescription sent over for Enbrel. awesome.

I called the doctor back and after being put on hold explained the situation. She put me on hold again and then came back stating that she was sorry and it never was sent over, the woman with her was on the phone with my insurance currently and it would be taken care of immediately. I then went online to Enbrel Support to register some extra insurance card thing. It’s unclear to me what it is besides subsidies for Enbrel. I don’t know who pays for it (probably tax payers?) or why I get it, but I do, so I tried to register. It sends you through a variety of questions and asks for contact information and then you hit submit. Easy enough- I already had a card from my Rheumy with an ID number. OF COURSE, the site crashed three times.

Finally I gave up and called the 1800 number. I basically spent 45 minutes on the phone with a guy who although very nice, seemed to now know what he was doing. Even though I explained that I had a card already and had just started taking Enbrel, he continued to ask me over and over how many years I have been on Enbrel and if I was just trying to renew my membership. 45 minutes later, he assigned me new numbers and a new card (god only knows when that will get here). The upside: I was able to use the numbers without the card.

I went to CVS to pick up the prescription. After a little wait the pharmacist brought out the Enbrel from the refrigerator (yay!). I handed over my temporary Enbrel support card and he looked very confused and then told me I would have to wait. Fine. About 20 minutes later, they called my name. I’m not sure what they did or what black magic they used, but bam! I had Enbrel! The even better part? IT WAS FREE! No, seriously. I didn’t have to pay one cent for FOUR injectors. I’m not sure why or how, but I will take it.

Down-Side: About 2 full days of my life wasted trying to get a prescription of Enbrel
Up-Side: Four injectors were free

Giving Yourself Enbrel at Home:
In case you’re wondering what the process is like… this is the set up along with the steps you take to successfully give yourself a shot.

 

 

1. Gather Accessories Andrew’s sister-in-law mentioned that it is less stinging if you take the Enbrel out and let it warm up for about 10 minutes. So I tried that…

2. Wash Your Hands– didn’t take a picture!

 

 

 

 

 

3. Swab the Injection Area with Alcohol Swab– note to self, remember WHERE you swab or you will have to do it again. Also, let alcohol dry BEFORE injecting (less stinging).

4. Remove the White Cap from the Injector– the white cap is what covers the needle. I use my teeth to pull it out- works better when you are trying to do too many things at once.

 

 

 

 

 

5. Pinch Area of Skin Where Giving Injection and Hold– this is weird. My doctor told me to do this, although the directions in the kit say to stretch the skin. Either way, I’m sure it is painful.

6. Ensure there are Not a lot of Extra Air Bubbles in the Liquid- They say to do this, but honestly, the more you tap the little liquid, the more bubbles that appear…

 

 

 

 

7. Push the Injector Down Hard- I’m pretty sure the reason is this pushes the needle into the skin. Surprisingly enough, I’ve found myself freaking out with anxiety over the impending stinging of doom that I can really feel the needle. Oh, in addition, the window viewer should be facing you so you can see the liquid draining (I don’t pay attention to the window, usually my eyes are closed and I just listen for the second click).

8. Press the Blue Button on Top- Stinging commence. No really. A lot of stinging/burning. Awesome. When you press the button, you hear a click. The liquid starts to go into your thigh. It feels a lot like a bee with a long stinger that is pushing the stinger deeper and deeper into your leg. You wait. A. really. long. time. Then it clicks again, signally that you are done.

 

 

 

 

9. Remove Injector and Discard into Sharps Container- I’m not really sure what to do with the sharps container once it’s full, but apparently Enbrel Support will give you a new bigger sharps container. Cool, right?

 

 

 

 

 

 

10. Use Gauze to Stop Bleeding and Cover with Mini Band-Aid-Not much bleeding this time! And you’re done!