Billye--I do not like how swollen you are. Being swollen can cause the blood counts to look lower, because, if you are retaining water, the red blood cells get diluted.

It is urgently important that your internist tease out the various things which can cause this much edema:

congestive heart failure: physical exam, looking at the distribution of the swelling, looking at the veins in your legs and neck and seeing how they are doing, listening to your lungs and heart, and getting a chest xray, at a minimum. Maybe more things, I don't know. Pericarditis---chest pain? Shortness of breath

liver disease: It does not seem as likely, as your liver numbers are normal.

kidney failure: blood tests like BUN and Cr show this

hormone problems: too much cortisol being made by the adrenal glands, too much being taken as medicine.

Drug side effects: Can the methotrexate or humira do this? How?

I'm worried. I think your problems are urgent, and that your internist needs to treat you as if you are urgently ill.

Is your rheumatologist your internist? I know he's the guy who is giving you calcitonin for your osteoporosis, when my bone guy here in NY, when I told him about you, said that that's nuts; it's too ineffective, and anyone with fractures from osteoporosis should be on Forteo. I hope he's up to this and is taking it very seriously.

Billye, you sound more ill than you've been, in a different way. I dont know enough about sjogren's or your medications to say anything sensible about what is happening to you, but please, make a fuss about being treated as if you are very ill.

Ok?