Meloxicam/Arthritis/Enthesitis

2021

I’m trying Meloxicam.

I’ve actually had it before – the previous rheumatologist prescribed it at half my current dose (15mg/day). I didn’t realize I needed to take it daily. Also the enthesopathies weren’t as numerous or frequent as they are now, so I can’t say whether it made much of a difference.

Here’s the thing: I have “inflammatory polyarthritis.” Like “pneumonia” it’s a synonym for a symptom, not a cause.

The pcp refers me to a specialist. I’ve been to 3 rheumatologists in 15 years. They send me to orthopedists and physical therapy. I see a different doc for every joint: shoulder, ankle, knee, hip, back. The ones who make a connection? “See a rheumatologist.” The rheum says “see an ortho.” Go ask your dad. Go ask your mom.

It’s not my job, man, phrased as, “we don’t handle that here.”

I’m not hellbent on any particular diagnosis. Or any particular drug. DMARDS, biologics, or even industrial strength NSAIDs like Meloxicam. But even though enthesopathies aren’t taken as seriously as arthritic joints, (or even red, warm, inflamed enthesitis-es), there can be just as much damage. The connective tissue can calcify. And some of these drugs prevent or slow damage in enthesopathies.

I’ve been looking for answers for 15 years. I really don’t want to wait to see if the calcification in my hips gets worse. If the tendons in my left hip – that feel like they’re going to rupture like the ones in my right – finally give way.

I’ve actually put in writing to my providers that I am “already on disability, not looking for pain meds, and am not here for attention.” That I need collaboration; help in solving this problem.

So this is where I’m starting, and I’ll see what happens 🙂

Update:

5 weeks after increasing my conditioning exercise, I started taking the Meloxicam. I had been taking it pretty easy, and feeling a little stronger about 3-4 weeks in. I was trying not to inflame any enthesitis. Still had pain in the entheses of the hip (upper hamstring and obturator internus and hip pointer), just below the knees, and several places in the elbows and shoulders.

In the last few days have I been able to intensify exercises to the point of muscle soreness. Without bothering the entheses. This is huge. If I can do this, I might be able to return to running. The limiter on it has always been the upper hamstring insertion (ruptured).

3 months in, I’m running again. Sort of. About 5 one-minute sessions, 3 times a week. But this is as far as I’ve ever gotten. The limiters are my knees (increased weight doesn’t help) and asthma (it’s just that season).

I’m going to gradually increase running and also start some new movement goals over the next few months. As with all meds, I’ll re-evaluate. But so far it’s been fucking great 🙂

Glucosamine/Arthritis

Glucosamine and Arthritis 2019

I stopped taking glucosamine at the start of this experiment. It took a week or so, but gradually joint pain increased. Things that hadn’t hurt started to hurt again, others that always hurt were worse.

I don’t have typical Rheumatoid Arthritis joint pain, with redness and swelling. My joint issues are soft tissue disorders, the worst being enthesopathies. I was playing soccer, landed on one foot and twisted, and heard a pop. The obturator internus separated from the hip bone. So did a third of my hamstring.

I’ve been diagnosed with everything highlighted above. Below is a pelvis. It’s not my pelvis. But I did have imaging of all kinds, revealing, the avulsion injuries, calcification on both ‘sit bones’ (where this image is pointing), and tendinosis on the upper outer hip.

When I’m at the gym, if I increase weight or reps to reach muscle fatigue, the limiter is a joint: knee, shoulder, elbow, wrist, or hip. If I push through the pain, I’ll end up with a tendinopathy that will keep me sidelined for weeks until it’s healed.

Not My Pelvis

Legendarily bad hips run in the family, in the very same people that had HD. My grandmother, who didn’t walk for the last 20 years, blamed the hips on her father. My aunt died from HD after 2 hip and 2 knee replacements.

Rheumatoid Arthritis and HD

“Depleting rheumatoid arthritis cells of HIP1 decreased their invasion capacities by nearly half, a property required by these cells to properly recover after cartilage and joint damage.”

Result?

I still have no answers for the joint/tendon issues. I suspect that since both skeletal muscle and bone density are affected, there will be further information on other connective tissue. Someday.
Until then, I’m back on the glucosamine. Within a week I was feeling better, exercising longer.