UPDATE - 09/01/08

Karen had another appointment with her rheumatologist this past week. It seems that frustration will continue to be the prominent feeling for at least a little longer, as we still have no diagnosis.

The PA at the rheumatologist's office feels pretty confident with a diagnosis of chron's , but has been having a difficult time getting any cooperation from the GI doctor. Apparently, he deems himself too important to speak with a lowly physician's assistant and is even willing to compromise the well-being of his patient for the sake of his apparently brittle pride.

While they are less often, Karen has still been having a few days where she is bed-ridden. The PA was a bit tentative about saying that this would ever cease, but did indicate that if they can get her meds right, they should come less and less often. She would really like to start her on a second medication, a biologic, but needs to consult with a GI doctor that is familiar with Karen's case. We have set up an appointment with a GI doc in the same building as her rheumatologist with the hope that they will be better able to communicate with one another.

Karen has been having persistent pain in her lower back lately. When she mentioned this to the PA, she ran some tests and discovered that Karen has a pretty significant kidney infection. They are treating this with a heavy dose of antibiotics. This infection is most likely due to Karen's diminished immune system caused by the Methotrexate and is likely a sign of things to come. We were really hoping the susceptibility to infection would be a side effect we wouldn't see for some time.

Finally, Karen is not getting much sleep. This is from Prednisone and will continue to bother Karen until they get all of the Methotrexate on board, at which time we hope to be able to wean her off the steroid.

While I realize the tone of this post has been pretty negative, Karen has been handling everything wonderfully. She is much better off than she was a month ago and I know she will continue to improve. Please keep her in your thoughts and prayers.