Many people who start along the cancer path already have some underlying conditions. I have no idea what the statistics on that are, but I am sure, anecdotally, that these can impact on treatment options, diagnosis, etc.
For me, it is a bit of a chicken and egg situation. I have absolutely no idea which came first, the cancer or the rheumatoid arthritis. I have no doubt that they have impacted on each other and as they have come along at more or less the same time it makes it very difficult some days to determine which illness is driving the problems I am having.
Other than the throat clearing and on off throat infections from spring / summertime onwards I had very few symptoms from the cancer. The rheumatism on the other hand was becoming more obvious as the autumn approached. It is only reading about the illness post diagnosis that I have started to wonder whether there were earlier signs that got missed. The signs in my joints became particularly noticeable from the October. During the holidays I decided to give my car a good clean over, as I was wringing the cloth I noticed my hands were starting to ache and I couldn’t quite wring them as dry as usual. The next day my wrists really ached and I noticed large swelling between my thumb and wrist on both sides. The aching didn’t go after a few days and I was back at work trying to carry exam papers across the school. I had managed to do this for years, but this time I had to stop a few times, but the box down and rest. I was really struggling with the weight of the boxes and noticed my hands swelling. After hitting Dr Google I used some local pain relief gel and bought some wrist supports. I started using these on the drive into work as I had noticed discomfort driving. After a couple of weeks with no improvement I decided to call the GP. We were still in Covid restrictions, so it was a phone consultation, I sent a couple of photos and was prescribed co-codamol. These didn’t really seem to relieve the problem, so I had some blood tests. Not surprisingly I got a call back (from a different locum, see a pattern here?) saying my bloods showed inflammation – no surprise there then Sherlock! I got stuck in this cycle for a couple of months and was then sent for x-rays on my hands and feet, as by this point my feet were also swelling. Nothing conclusive on those, so I remained undiagnosed.
Then along came the cancer diagnosis, with the joint swelling sending me into panic mode that it had spread into my bones. The GP gave me a good check over and couldn’t find other indications to support this fear which was a reassurance whilst I awaited staging. When I had the tonsillectomy my hands and feet were awfully swollen, to the extent I wasn’t given compression socks to prevent DVT, so I just needed to keep my legs moving as I recovered. On the plus side I was given slow-release ibuprofen, this had a fantastic affect on the swelling. When I mentioned this to my GP he prescribed me liquid ibuprofen (the hospital had notified them that all medicines needed to be soluble / liquid in preparation for the affect of the radiotherapy on my ability to swallow. I kept taking this and it worked fairly well until I had my PEG fitted and started chemo, where I was advised to stop taking ibuprofen as the risk of reflux was high and the last thing I needed for my throat was any more acid. Thankfully the steroids I was given along with the chemo reduced the swelling, in a bizarre was the mobility and lack of pain in my hands and feet gave me a marked chemo bounce through my treatment. This, along with the regular blood tests really supported by rheumatism diagnosis which came along nearly 3 months after chemo finished.
In the intervening time my joints gradually got worse. Without ibuprofen or steroids, I wasn’t taking anything to reduce the swelling. This meant that some basic tasks were really difficult. This is why I mention it when writing about my cancer journey. Many people I know have continued exercising, even if that is just walking the dog. I was absolutely floored, I ached, my joints were stiff and the fatigue was overwhelming. Looking back, I put much of this down to the combination of the absolute battering your body takes from the chemo-radiotherapy, but also the impact of the rheumatoid arthritis. Many of the symptoms / side affects are similar, so it is hard to pinpoint the root cause, and therefore determine the best treatment. The neck joints can become stiff from rheumatism, but I already exercise my neck and jaw twice a day to keep the trismus from radiotherapy at bay. The sulfasalazine I take for the rheumatism can lead to sore throats, my throat has been completely destroyed from the radiotherapy, I have had three off the scale colds / sore throats, twice needing antibiotics in my first post treatment / diagnosis winter. I notice my throat start to struggle whenever I get tired, more than ever before and it was always my Achilles heel. Which brings me to the fatigue, another chicken or egg scenario, is it caused by the radiotherapy and recovery from that, or the rheumatism? I doubt I will ever know. Before this chaotic year of upheaval, I was perimenopausal, the chemo saw to it that I am now menopausal. To be honest, it’s been a fairly smooth transition so far. However, I do get some serious brain fog. I can be halfway through a sentence and I have no idea what word I am searching for to continue, not very good in front of a class of teenagers! I was asked recently by a colleague what they thought was causing it, to which I replied, ‘goodness knows, there’s three possible factors, pick whichever you want’.
On a positive note, I don’t worry about it, its just how I am now. Grateful to be here, even though in some ways I am a bit of a shadow of myself. I have got used to the constant rotation of medical appointments, I tend to remember which arm my last blood test was taken from so that I can alternate and rest my veins. These are small prices to pay in return for still being alive. Although, it does get frustrating that I seem to have beaten my lifelong nemesis of cancer only to have to face the prospect of early retirement as my body slowly makes working more challenging thanks to the rheumatism. Anyone else ever had these frustrations?
