Wednesday, June 16, 2010

Another Dr's Appt

Okay here we go!
Seriously, can I ever get the same doctor? The VA hospital has so many interns that I feel like I should carry a video with me
each time that I go because I see a new intern each time and have to explain everything over and over again!
It is such a pain in the backside!
Then when you tell them your concerns about weight gain and/or weight loss does anyone ever listen? Why do they ask you
if you have concerns if they are not going to listen to you! Because telling me that maybe I don't know how to count calories correctly or that maybe I'm not aware of my metabolism slowing down because of age? Really!
So first they tell me I'm stupid and now they are calling me old! HELLO!
Are they waiting for me to lose my mind and begin complaining about depression!

Now they want to increase my methotrexate from .7 to 2.o and add Sulfur-Salazine

Sulphasalazine and lung toxicity. S.D. Parry, C. Barbatzas, E.T. Peel, J.R. Barton.
#ERS Journals Ltd 2002.

ABSTRACT: Sulphasalazine prescribing is on the increase. Pulmonary toxicity and
blood dyscrasias are rare side-effects. Numerous case reports have been published
implicating sulphasalazine in pulmonary toxicity. The authors searched the literature
for cases of sulphasalazine induced lung toxicity and the 50 cases identified are
discussed here.
All published case reports/letters referring to sulphasalazine and lung toxicity were
studied. The search terms "sulphasalazine" and "sulfasalazine" were combined with the
terms "lung", "pulmonary disease", "pneumonitis" and "pleuritis" using Medline and
PubMed databases.
Typical presentation of sulphasalazine-induced lung disease was with new onset
dyspnoea and infiltrates on chest radiography. Common symptoms were cough and
fever. Crepitations on auscultation and peripheral eosinophilia were noted in half of the
cases. Sputum production, allergy history, rash, chest pain and weight loss were
inconsistent findings. Pulmonary pathology was variable, the commonest being
eosinophilic pneumonia with peripheral eosinophilia and interstitial inflammation with
or without fibrosis. Fatal reports were infrequent. Most patients were managed by drug
withdrawal with 40% prescribed corticosteroids.
In conclusion, sulphasalazine lung disease should be distinguished from interstitial
lung disease due to underlying primary disease. Despite the increase in sulphasalazine
prescribing, pulmonary toxicity remains rare. The majority of patients with suspected
sulphasalazine-induced lung disease improved within weeks of drug withdrawal and the
need for corticosteroids is debatable.

That is what it is! So Going from bad to worse! I'm going to be taking 2000 mg per day!
Really! How does this show that they heard me when I said any issue about weight.
This is just giving me more crap to take!

So until next time, pray for me and I will continue to pray for you!

School is almost done! Two more days....


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