Odd Flare

[refinnej30]

First let me say I'm so thankful for you Mike.

I'm having a very odd flare. I am HLA B27+ and for the most part have been quiet for the last few years. I've done immunosuppresant therapy and had to stop due to infections.

I had turbinate reduction surgery March 7 2013 to open my nasal passageways. The surgery worked well and I was finally sleeping. The about 2 weeks ago I got a migraine that eventually turned into eye pain on my left side (the side I get flares on.) It then switched over to the right side and the right eye and the left side felt better and the eye cleared up. I figured it was a migraine. This Monday I went to the Dr and was told to take Mortrin. That night I ended up in the ER with horrible pain was given pain meds and steroids and sent home. I saw my local ophthalmologist who I go to when I have a flare until I can see Dr. Foster. He said it was a 1+. I've been on Pred Forte every two hours and Homatropine 2xs a day for 5 days and my eye is just as bad if not worse. This has not been typical, it doesn't feel like a flare. My head still hurts a little and my eye isn't getting better. I always heal very quickly and have never had this issue. Can an infection mimic iritis? I don't have a fever (but rarely get one even when I have a acute infection) my sinuses hurt still, my teeth hurt, my eye is red looking and angry even after 5 days of treatment, but my Dr. told me I don't have an infection.

[Mike Bartolatz]

I can't answer this question. only a doctor can do this. call DR Foster's office and get in right away. he always has a slot available for situations like this or DR Hinkle will get you in.

you have existing uveitis. it can be triggered by inflammation or infection anywhere in your body. the key is to get this calmed down as quickly as is possible right now. you are in pain and need medical attention. only someone like Dr. Foster can help you with this.

wish you the very best,
Mike

[refinnej30]

Put in for a referral with the military to see Dr. Foster and told them it was an emergency. Hope to see him no later than Thursday. I already know he's going to put me on a dmard and I guess I wanted to avoid it. I had 11 infections with Methotrexate in 16 months. I am now allergic to almost 10 antibiotics.

I am very frustrated and tired of HLA B27 Iritis . I am tired of doctors that don't have a clue and tell me I need a shrink because they can't find the source of my pain. It took 27 doctor visitsto figure out I had a nasal obstruction that was preventing me from sleeping. I was prescribed narcotics and narcolepsy meds to help with pain and to keep me awake because I couldn't sleep. I finally had surgery and can breathe, but then flared and was told the two had nothing to do with the other even though the flare happened 2 weeks after surgery. Sorry needed to vent.

I guess I am concerned with the side effects of the Dmards. I just lost a friend to lymphoma and don't really want to go through what she went through. Going blind looks to be a better alternative. My body went crazy after MTX and I really don't want to make it worse. My body is so sensitive, I'm not sure what to do at this point. I know steroids are bad. Another issue is we are transferring in 7 weeks to St Petersburg Florida (from Cape Cod, MA) and I don't really want to move without an immune system. We are hoping getting off the Cape will help as my body has not done well here. My eye is still tender and no where near better so something else has to be going on. I'm beginning to wonder if it really is a flare at all.

Thanks

[Mike Bartolatz]

the tender to touch eye might be a symptom of Scleritis. if you can't get in to see DR Foster, see DR Janet Davis or DR Victor Perez at Bascom Palmer eye institute in Florida, you might ask to be tested for the IL23R gene sometimes found along with ankylosing spondylitis, Crohn's disease, autoimmune thyroid disease, Systemic Lupus Erythematosus, Behcet's disease and rarely breast cancer and sarcoidosis. if this is present the drug Stelara might help. if IL1B is present then Anakinra might be tried if you fail Remicade or Humira down the road.
the IL1B gene is found in many of the above conditions as well as type II diabetes, Juvenile Ideopathic Arthritis etc.

I hope you can get in to see DR Foster as he is the best in the World. I know he sees VA patients and perhaps active military. contact Frances Foster at MERSI

take care,
Mike