Arthritis of left hand

Yesterday we drove to Denver, to keep an appointment with Dr. Jeff Matous, our 'super-specialist' in Myeloma. Dr. Matous was in charge of Doug's stem cell transplant; we see him about once a year and think very highly of him.
Dr. M thought about Doug's recent history of persistent left hip/low back pain, despite radiation therapy. He said MRI would be helpful to see any new bone lesions. Since Doug can't have an MRI due to his pacemaker, Dr. M. said a CT/PET scan would be the thing to do. A regular CT scan can't tell the difference between old bone lesions and active 'hot' lesions, but CT/PET would. So if/when that pain comes back, we have a plan. Dr. Matous is thinking that perhaps Doug's pain could have nothing to do with the myeloma. He also said Doug should change Revlimid maintenance dose from 10 mg. down to 5 mg. This is because the white blood counts are going too low. But he is still in remission.

A new problem - day before yesterday Doug's left proximal thumb started to hurt. Yesterday morning it was a bit swollen and still hurting. By the time we were waiting for Dr. Matous to come into the exam room, the hand/thumb was very swollen and exquisitely tender. Dr. M checked it out, didn't think it was infected, and called his orthopedic buddy. We ended up going first to a vascular doctor's office for an ultrasound, to rule out a clot or abscess, then over to the orthopedist's office. The ortho doc said this was an unusual presentation - such quick pain without trauma. He took an X-ray which showed arthritis of the proximal thumb joint! That was a surprise. The doc put a splint on Doug's hand and recommended ibuprofen to reduce inflammation. He said steroid injections might be necessary in the future.

There is a medical saying: "If you hear hoofbeats, think horses, not zebras." With Doug's history, the first thing is to think of myeloma causing bone pain. But other things like arthritis can also be the culprits.

Doug feels better today, after a night's rest. We didn't get home until 9 p.m. last night - 8 hours in Denver, three physicians offices instead of one, and four hours travel time. We are very glad that Dr. Matous arranged all that to happen in one afternoon. Doug is really in good hands. And yes, he managed to drive both ways despite his pain. That's my guy.

Love to all.