Made it back to the rheumatoid arthritis doc on Friday. More tests... and only a small amount of waiting. Expected to have to sit, as the appointment was set for 11:20 with the doc. That normally would mean, at this office at least, that we would have an hour in the waiting room, before the nurse even checked us in. Within 3 minutes of getting to the office, they were calling his name. Scales showed the same weight loss amount, so sorry hon... the scales at the other two offices were right on track. Three offices in 2 days with the same weight does mean that the lack of appetite and food intake did result in a ten pound weight loss.
The nurse finished her check in. We always get a sheet of paper that requests all info over the last one month time frame. No problem normally. Virg has me fill it out, asking him all the subjective info that I can't judge. I know if there has been a fever etc. I have no idea of the left elbow verses the right elbow is raising fits... i just know for fact what the back is doing to him.
Doc walks in less than 3 minutes after the nurse enters the room. He states surprize that he had not looked at bone density before now. He goes over treatment options. There is a pill that you take every day. Prevents further loss, but chews up the stomach very effectively. Not a good option, as Virgil already has an extremely sensitive stomach with all the other drugs he has to take orally. There is an IV option, that after two beginning doses, you have administered in doc's office over a 20 minute time frame. Ditto. Does not rebuild bone, just halts further loss. Causes problems frequently with the IV site, and is not a good option with someone on therapy for blood clots. The numbers on the density scan are not good. The hip area comes in at 1.5, meaning not great, but not likely to shatter just standing... the backbone, on the other side... ranges from 2.4 to 2.9. 2.9 is the highest bone loss that registers on the test. Doc explains that there is a self inject-able treatment that we can do at home. It requires a shot into thigh or stomach once daily. There is a limit to how long the FDA will approve anyone getting this treatment, due to rats developing cancers after two years at a very high level of this drug, states 100x what any treatment amount would be. States there is a remote possibility of bone sarcomas following treatment, but very, very unlikely... the plus side... it rebuilds bone. Not back to the levels he was at in his 20's, but much less likely to shatter out another vertebra just breathing. Forteo. Seems it runs about $900 monthly for the therapy. Doc said before they actually write out the script, the office verifies for us that our drug plan will cover it. I did call the drug company to verify if the drug was covered myself. Able to verify that it goes through the specialty pharmacy, just like how the Humari is delivered. Should hear from the office today, and will call the specialty clinic once I do.
I asked about all the numbers on the test, as i had already done my research. Bone density tests were never something I had to deal with on a day to day basis. If we found a fracture, we simply sent the person to surgery, and then to their docs office for follow-up. Bonus... he pulled up the MRI and showed it too us too. Clear as day, showing the fracture and also showing another site just moments from fracture. Deep divets into the bone surface. The fractured bone is for certain Thoracic 8... the one ready to go is Thoracic 5. Nice to see, and not spend the entire weekend wondering what the tests would show. Shows all kinds of swelling and irritation of the spinal cord.
So now we are waiting for a phone call to state we should start therapy of what sort... and going to see the surgeon this am. Time has come already to wake Virg and get him into clothes. Grateful that the weather is above freezing today. Praying for a quick appointment, and being able to get him back home and as comfortable as possible for today. And praying we can set a surgery date. Time will tell....
The nurse finished her check in. We always get a sheet of paper that requests all info over the last one month time frame. No problem normally. Virg has me fill it out, asking him all the subjective info that I can't judge. I know if there has been a fever etc. I have no idea of the left elbow verses the right elbow is raising fits... i just know for fact what the back is doing to him.
Doc walks in less than 3 minutes after the nurse enters the room. He states surprize that he had not looked at bone density before now. He goes over treatment options. There is a pill that you take every day. Prevents further loss, but chews up the stomach very effectively. Not a good option, as Virgil already has an extremely sensitive stomach with all the other drugs he has to take orally. There is an IV option, that after two beginning doses, you have administered in doc's office over a 20 minute time frame. Ditto. Does not rebuild bone, just halts further loss. Causes problems frequently with the IV site, and is not a good option with someone on therapy for blood clots. The numbers on the density scan are not good. The hip area comes in at 1.5, meaning not great, but not likely to shatter just standing... the backbone, on the other side... ranges from 2.4 to 2.9. 2.9 is the highest bone loss that registers on the test. Doc explains that there is a self inject-able treatment that we can do at home. It requires a shot into thigh or stomach once daily. There is a limit to how long the FDA will approve anyone getting this treatment, due to rats developing cancers after two years at a very high level of this drug, states 100x what any treatment amount would be. States there is a remote possibility of bone sarcomas following treatment, but very, very unlikely... the plus side... it rebuilds bone. Not back to the levels he was at in his 20's, but much less likely to shatter out another vertebra just breathing. Forteo. Seems it runs about $900 monthly for the therapy. Doc said before they actually write out the script, the office verifies for us that our drug plan will cover it. I did call the drug company to verify if the drug was covered myself. Able to verify that it goes through the specialty pharmacy, just like how the Humari is delivered. Should hear from the office today, and will call the specialty clinic once I do.
I asked about all the numbers on the test, as i had already done my research. Bone density tests were never something I had to deal with on a day to day basis. If we found a fracture, we simply sent the person to surgery, and then to their docs office for follow-up. Bonus... he pulled up the MRI and showed it too us too. Clear as day, showing the fracture and also showing another site just moments from fracture. Deep divets into the bone surface. The fractured bone is for certain Thoracic 8... the one ready to go is Thoracic 5. Nice to see, and not spend the entire weekend wondering what the tests would show. Shows all kinds of swelling and irritation of the spinal cord.
So now we are waiting for a phone call to state we should start therapy of what sort... and going to see the surgeon this am. Time has come already to wake Virg and get him into clothes. Grateful that the weather is above freezing today. Praying for a quick appointment, and being able to get him back home and as comfortable as possible for today. And praying we can set a surgery date. Time will tell....
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