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Went to New Rhuemy today..

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Rheumatoid Arthritis
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Posted 8/21/2010 12:20 AM (GMT 0)
Hi everyone,

I haven't really posted here in awhile. I have answered some of your post but have been over in the chronic pain forum. Last time I was here I was waiting on a second opinion about RA and or PSA.My old Rhuemy had just blown me off and chalked it all up to Fibro. After I had two rounds of predisone(for a herniated disc) and the stiffness in my hands, knees, elbows, and knees, feet and toes sometimes had stopped.. I knew this wasn't fibro. Fibro is just how your body interprets pain..like a misfire. I am not saying I don't have it but this other pain and stiffnes started about 9 months back seperate from the other. I was having dizziness, and exhaustion even after 12 hours of sleep..extreme thirst(been tested for diabetes and don't have it) and dry eyes like glass is in it. My Rhuemy blew off the elevated crp test as well. So I went to this new one. He was really great. Put me on an anti-inflammatory.He listened, asked a million question,even took notes on what I said, sent me for blood work, did a full joint exam, and x-rays. My old Rhuemy in the year I have been seeing him hasn't done any of that. So my curiosity is getting the better of me. What could the x-rays show? I thought mri's were the best when looking for RA or PSA? He said because it gets expensive that we would x-ray my hands only for now since that is where my pain and stiffness started. They took 10 viles of blood so what is that for? The norm..ana,sed rate? I just want to know. He will be calling me in 5 days with the results but after a year of crap from my old Rhuemy I'm dying to know something. Thanks for any info..Heather

Posted 8/21/2010 1:50 AM (GMT 0)
Sounds like a very productive visit- I'm so happy for you! Let us know what the tests reveal! All the best to you that you are able to pinpoint things so you can find a solution that brings full relief!
Posted 8/21/2010 6:42 PM (GMT 0)
Thank you. I am really nervous about the whole waiting but I guess if I could wait a year and be no further along then i can wait 5 days to find out something. Heather
Posted 8/22/2010 12:55 AM (GMT 0)
I have had RA for 14 years and never had an MRI to look at that (had one for a nerve problem) the X-rays will show small errosions in the joints of your hands and feet-expect to have them done once a year if it determined you do have RA.
Blood-most likely CBC with diff and platelets, Complete metabolic panel (to check liver and kidney function) ESR and CRP (to measure inflamation), thyroid screening, ANA, Anti CCP, Anti DNA, and a few other tests to differentiate/diagnose between autoimmune disorders if you have one.
Sounds like this new rhuemy is a good one.
Posted 8/22/2010 10:19 PM (GMT 0)
I'm glad you're getting things sorted :) seems like a pro-active department!

Whenever I'm seeing doctors regarding the privately funded clinical trial, I have 15 vials worth of blood work up, multiple MRIs, Xrays, all sorts - all on one way without any wait whatsoever. Then I go back to standard english health-care... and I'm lucky to have a liver function test for MTX :D

Mama - does this rheumatic pain you experience respond to NSAIDs* (i.e. Diclofenac, Ibruprofen, Arcoxia), if so I would be so bold as to suggest RA/PsA is exceedingly likely. I find my "other" pains (Fibro maybe?) are untouched by these, however mild-moderate PsA flares can be controlled with 50mg diclofenac.

I wouldn't worry about differentiating between PsA and RA too much as treatment is essentially the same. I think I may have RA with psoriasis, but trying to pursue a diagnosis would be pointless for me - I'd still be treated with MTX, TNF-Blockers, etc.

Take Care

(I think diclofenac is Rx-only in USA, and I have a suspicion Arcoxia isn't FDA approved)

P.S.
a large irony strikes me that you have fibromyalgia and are struggling to have PsA recognised - while I have PsA and can't get a doctor to recognise my fibromyalgia symptoms. - maybe we need to swap doctors ;)
Posted 8/23/2010 4:34 AM (GMT 0)
Doesn't dry eyes go with reynauds syndrome? Isn't that another AI disease? I don't know, hopefully this new rheumy will have the answers. X rays show joint (bone) deterioration, MRI's show up the tendon and ligament damage. As well as bone of course but they are expensive. I've never had one for my RA either but my rheumy talks of them for the future...
Best of luck, golitho
Posted 8/23/2010 6:08 PM (GMT 0)
Of course, it is perfectly possible to have RA or PsA without any deterioration on an X-Ray, or even an MRI. (I don't, only minor inflammation - ultrasound is very cheap and very good at this). If it looks like RA, feels like RA, and sounds like RA, I'd treat for RA and note any reduction in inflammation!

mama, about the bloods, I'd assume that you'll also have rf, crp, calcium, and maybe some genetic marker tests and a basic platelet/white blood count work up. If you have any concerns, ask them to walk you through what is taken and why, although I tend to take a back seat with bloods - I acknowledge they know better than me in at least that area ;)

T.c.
Posted 8/24/2010 2:59 AM (GMT 0)
According to this Rhuemy he couldn't feel,in my hands, what they would normally feel as for inflammation that goes along with RA. He then went on to say that we need to wait for the test to come back because of my history. He kept asking why when I started having other symptoms along with the elevated crp why they didn't do x-rays or such and I just answered I don't know. It was suggested that it wouldn't be a good idea to bad mouth my old Rhuemy so I didn't.

He then prescrebed Relefan an NSAID. I just started taking it and he said it may take up to two weeks to feel some difference. It was the first time I had been prescribed an NSAID..in over two years. At the time they had presc. them in the past it was meloxicam and I didn't notice any difference..I was having way more of the muscle pains and such though, not what I am having now(or if I did it wasn't as painfull as what is going on now). So we will see.

Thanks for all the great advice. It def. helps.

He handed me a stack of orders for blood work..not kidding but like between 20-40 pages with each order on each page. I tried to read them in the elevator to see but didn't get through but a couple. I know I should have just asked. I think I was more in shock, that he was actually being proactive. Haven't heard anything yet. Anxiously waiting. Heather

Posted 8/26/2010 12:34 AM (GMT 0)
So happy for you that somebody finally is taking care of your health - looks like that! Good luck, keep us updated!
Posted 8/26/2010 4:43 AM (GMT 0)
Gpood Evening all, A good rhumy is very important. I am fortunate to have an outstanding one. She really knows her stuff.
Posted 8/27/2010 10:02 PM (GMT 0)
Well got the call. The x-rays came back normal..which really did surprise me. The test came back, according to them.."somewhat ok". the Dr. wants to discuss it with me in 2 weeks at my next appointment. I doubt that really means anything, but we'll see. So I guess my body is just dumb. I don't know why I get the stiffness and pain that does better with predisone. Don't know why crp levels are elevated. Have to wait and see I guess. heather
Posted 8/27/2010 11:34 PM (GMT 0)
Good for you! My x-rays showed small corrosion in the little finger of right hand, maybe if I would start Plaquenil when they told me to it wouldn't happen. To late now... Take care of yourself!
Posted 8/28/2010 1:42 AM (GMT 0)
It can take up to two weeks for the bloodwork...but your appointments seem to have gone good...
It's nice to get a pro-active type Doctor, sure hope everything goes good on the bloodwork...
If you haven't seen an eye doctor about the dry eye's please go see one...restasis can help.
((((((((((((((((((((((Mama6)))))))))))))))))))))
healing hugz
Posted 8/28/2010 10:36 PM (GMT 0)
Thanks for the support!! I wish i new something more. It is hard to sit around and wait. Funny though, been waiting all of this time anyways but as soon as they did the bloodwork now it seems to be dragging so much more. I will post when I know more. I am so happy I found two good Dr.'s after all the ...wellllll....let's say underqualified ones. I hope you all have a great weekend. Heather
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