Sunday, May 15, 2011

The Queen of Nodules

I am becoming the queen of rheumatoid arthritis nodules.  I discovered a new one the other day on my finger.  Part of my freak out procedure is to have everyone near me feel it to verify that I am not making it up in my own head.  Sophia was the lucky one this time since we were in the car together. 
Me:  Feel this.
Sophia:  Oooohhhh...what is that?
Me:  Another nodule.
Sophia:  (No need to explain nodules to this 13 year old.  She completely understands the word). Don't worry.  You still look pretty.
Me:  Yeah, people will say, "From far away she is pretty, but once you touch her, she is all gross and bumpy."
Sophia:  laughs.

At one time in my life, these small changes in my body created a huge fear.  Now, I have a momentary freakout and then I move on remembering that even though a new nodule has become part of my body, my body is also doing some rather amazing things.  Instead of thinking of them as deformities to my body, I think of them as trophies.  They represent the hard work I have put into healing and stay with me as a reminder of what can be and what has been, but not necessarily of what is right now. 

According to WebMD:
  • Rheumatoid nodules usually occur in patients with severe RA. Nearly all RA patients with nodules test positive for rheumatoid factor." (Yep, that's me.)
  • Rheumatoid factor is positive in 70% to 80% of people with RA. Studies show that when RA is linked with a positive rheumatoid factor test, it may indicate more aggressive disease. (Yep, that's me.)
  • Other factors may increase the chance of RA nodules. One study found that cigarette smoking increases nodules in patients with RA. (Nope, not me.) Methotrexate, a commonly used RA drug, has also been linked to increased development of rheumatoid nodules. (Yep, that is me.) Sometimes disease-modifying antirheumatic drugs (DMARDs) can reduce the size of RA nodules. But patients who take methotrexate may develop an increase in size and number of nodules. If nodules are thought to be a result of methotrexate treatment, a change in medication regimen may help; however, this decision must be carefully made on an individual basis.
Since I have developed several nodules throughout my body the last few years, my rheumatologist has mentioned that methotrexate can be a contributor to the nodules and wants to watch them.  Although I just found this newest module the other day, I planned to bring up reducing my methotrexate last week at my appointment, but I forgot.  I will remember it for next time.  Since my lab work has looked fantastic the last few times and I feel well, I don't think she will have a problem with it. (Oh, we did a new chest x-ray too because she had concerns of nodules developing on the lungs but the x-ray came out great this time!)  We did talk about reducing medications once I felt better when I agreed to go back on them.  I hope she agrees with me, but whether she does or not, the decision is always up to me.  It is my body after all, nodules and all!