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An arthritis story...

Some of you may wonder what the purpose of writing an article about rheumatism is on a metallurgy blog, but I thought I should convey my experiences with this disease, which has deeply affected my life for about 9 months.

inflammatory rheumatoid arthritis, enbrel, methotrexate, mtx

The experiences of those who have experienced this disease before are as important as the doctors, so you can read this article as the story of falling from a roof . The medications I use and the treatments applied may be different from yours. Please do not try to use the medications mentioned in this article without consulting a doctor.


But you're younger...

Yes, I am young, thank you, but this is not the senile rheumatism that your mother-in-law's mother or your neighbor's mother-in-law has. Yes, the name is the same, but the disease I will talk about in this article is inflammatory joint rheumatism, also known as joint rheumatism. Rheumatism disease can be seen at any age. Therefore, it should not be considered as an old age disease. When I came across this disease, I did a little Instagram search and saw that it can occur even in children as young as 2 years old.


What is arthritis?

Rheumatism is used to name all diseases that affect bones, joints, tissues around joints, and even nerve roots. In other words, it is the general name of painful diseases that manifest themselves in muscles and especially joints.


Spondyloarthritis, swelling in joints such as shoulders, knees and wrists.
Inflammatory joint rheumatism can cause edema in many small or large joints.

The most common types of rheumatism in society

Osteoarthritis - senile rheumatism

rheumatoid arthritis

Soft tissue rheumatism (fibromyalgia, neck pain, low back pain)

osteoporosis

acute joint rheumatism

Spondyloarthritis - The disease I suffer from


You won't believe it, but the reason is unknown.

From where? The country's people's favorite question. Almost everyone asks this after the "I'm so sorry" stage. If I knew, I would tell you, but not me, the medical world doesn't know. To all of you who say "Oh, it's because you exercised too hard, you lost too much weight, or you're working under stress," I'm sorry to say that the reason is unknown. Rest assured, I am more curious than you.


How did I fall off the roof?

After making the introduction, I can start to explain how I fell off the roof.


Those who know me know that I have had a sports life that includes swimming, cycling and running for about 10 years. I exercise around 7-8 hours a week. You can follow my workouts from the Strava link below.


Throughout my sports life, my illness story started with a pain in my neck on December 24, 2020. When I first felt the pain, I was doing weight training and thought it was a classic stiff neck. With the advice of an orthopedist friend, I used painkillers and muscle relaxants. Even though I seemed to have recovered a little, my neck still gave me limited range of motion. I cycled and ran this way for a few days. When I woke up on January 7, I saw that my right ankle was swollen than I had ever seen it before. Naturally, I went to the doctor.


After the MRI and examination, I started physical therapy.

I had an MRI for my neck and right ankle, which I was having trouble with. According to an orthopedist's comment, I had a cervical disc herniation and an ATFL tear in my right ankle. A cast might be required after the swelling subsides, and I should definitely not step on it. I needed plenty of ice and elevation for my wrist and a neck brace for my neck. I had to start physical therapy simultaneously.


Spondyloarthritis, rheumatoid arthritis, ankle swelling, methotrexate

After these diagnoses, I went to Physiotherapist Tarık Çetin , whom I had met before due to my sports injuries. I continued physical therapy 3-4 days a week, but there was no improvement and I was getting worse day by day. On January 20, 2021

My physiotherapist asked a question like this.

Could you have rheumatism?


Of course, since I could not have the answer to this question, the first thing I went to was my orthopedist friend, whose name I will not mention here, and when I received his harsh reaction, I remained silent and continued with physics.


The reason for the troubles is about to become clear!

When I woke up on the morning of February 11, 2021, I had serious pain not only in my right ankle and neck, but also in my left knee, left shoulder head, left elbow and breastbone. I got up from the bed with difficulty and immediately went to MedAmerican Orthopedist Mithat Dokur . After the examination, he said that I should go to a rheumatologist with the suspicion of rheumatism.


New chapter in my story:

With a quick research, I learned that there are not many rheumatologists in our country. Since we live on the Anatolian side of Istanbul, I looked for a doctor there but could not find one. On the same day, I made an appointment with Rheumatologist Banu Güneş , one of the doctors of the American hospital. As a result of more than an hour of physical examination and MRI examinations, it was concluded that I had a rheumatism disease. Additional blood, urine tests and genetic research were performed as requested.


inflammation in urine

As a result of the urinalysis, I was found to have a urinary tract infection, the cause of which could not be determined and which was hidden (without causing any discomfort to me). Thereupon, my doctor said that the condition might be reactive arthritis and that once this infection ends, I will start to feel relieved and the disease will end. But despite the antibiotics I used, I could not achieve any improvement.


Things get complicated. New treatment Methotrexate !

I don't like to make judgments on subjects on which I am not an expert. That's why I gave the wikipedia link immediately. Methotrexate is essentially a chemotherapy and therefore a cancer treatment drug. When you hear the name, you get scared, but when you search on Google, you feel even worse. But let me tell you in advance that there are hundreds of thousands of people in the world who use both injections and pills.


When my doctor Ms. Banu gave me this medicine, I needed another opinion and Prof. Dr. I made an appointment with Vedat Hamuryudan . What she said was almost the same as Ms. Banu, so my new hope in the fight against the disease was MTX.


Since rheumatoid arthritis, in its broadest definition, is an autoimmune disease and my own immune system attacks my own joints, this drug tries to prevent the attack by reducing the immunity. It is a bit difficult to see the benefits immediately, it takes 8-10 weeks for it to start working properly.


By the way, let me tell you a little about my pain as of March 2021. My right ankle is swollen but does not cause any major problems, but my left knee is now preventing me from walking. My neck allows me to drive and go about my daily life, but I still have difficulty turning it left and right.


The vaccine is out. Should it be Biontech or Sinovac ?

The state decided to vaccinate immunosuppressant users against the risk of corona by the end of March 2021. Both doctors I contacted said that I should be vaccinated. They both agreed on Biontech. I had the first dose on April 3. Of course, in order to receive this vaccine, it is necessary to take a break from methotrexate. My April was actually a quiet month, in terms of illness.


May 2021 was a nightmare for me!

On May 1, I received my second Biontech vaccine, unaware of what would happen to me. 5 days after the vaccination, I was unable to get out of bed. My ankle, left knee and neck were very bad. I also had Pustulosis palmaris et plantaris, a type of psoriasis, on my right foot. This time, a dermatologist was added to the hospital visits.


I started using cortisone...

Due to the bad course of the disease, my doctor Ms. Banu said that I should start cortisone. However, although cortisone caused a downward trend in my blood values (CRP and Sedimentation) in the first two weeks, it did not contribute much afterwards. It even caused incredible stiffness in my legs. My leg stiffness continued for the two months I used it.


Prof. Dr. Meeting Ahmet Gül

Let me tell you in advance that I did not have the slightest problem with my previous two doctors, but when there is no positive development in the disease, one inevitably starts to tinker. Believe me, I read hundreds of websites and dozens of scientific articles during this process. I received opinions from many doctors who are close friends and acquaintances. I telephoned, corresponded, etc. with people who had experienced this disease before.


When I met with Ahmet Gül on June 12, he expressed two issues. Cortisone did not help my disease and the second dose of vaccine further exacerbated the disease that was not fully controlled. I had to not walk because the edema in my knee was intense. I couldn't walk anyway. But the teacher said I had to move somehow and suggested swimming. Even though it was difficult, I tried to swim two days a week and it benefited me.


Biological warfare begins!

After using antibiotics, painkillers, methotrexate and cortisone respectively, I had to use biological drugs called TNF Alpha inhibitors. Biological agents are an important type of medicine used in rheumatism treatments. I use Enbrel , which contains the active ingredient etanercept. I apply it to my leg with a pen-type injector every Friday evening. After the second week, there was a serious relief in my complaints.


Spondyloarthritis, enbrel click pen, biological medicine
The first one I applied was Enbrel. Friday, July 2, 2021

I'm getting better now!

After all this effort, a treatment method started to work for me. I first regained my mobility in my daily life by injecting Enbrel on Friday evenings and methotrexate on Saturday evenings, and then I returned to swimming and cycling.


Although I have not been able to run yet due to edema in my knee, I am in a very good condition, thank God.


There is no clear cure for this disease, but it is possible to control it. With the support of my doctors, I was able to get it under control in about 8 months.








During this process, I realized that every disease has a story. Patience is the most important point. It is not realistic to expect an improvement from evening to morning in such diseases. The most rational solution seems to be to fight with family, friend support and effective communication with your doctor, by following the changes in your body and doing sports as much as possible.


Finally, I gathered all the processes in a Gantt chart. The ones that appear in diamonds just below the date line are my complaints, and under them are the medications I use and their duration. At the top, there are the MRI, X-ray and blood tests I took, as well as the CRP and Sedim results.



naprosyn, deltacortril, methotrexate, folbiol, folic acid, enbrel, osteocare
As the disease and treatment became more complex, I decided I needed to use a Gantt chart.


Some web addresses for those who come to this site due to falling off the roof:





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