First Appointment Today....

I would be shocked if she doesn't think I have RA (or some other A); my boss is a rheummy who doesn't see patients anymore, and he told me to get myself seen!

So, I have had my symptoms for at least 3 months now: knees, feet, fingers, wrists, and elbows.  Pins and needles feelings (fingers), achiness (fingers, knees, wrists), sharp stabs of pain every once in a while (fingers/toes), feeling like my arms are on fire, elbow problems (you don't know what actions involve the elbow joint until you have a problem with your elbow joint, LOL).

Stiffness in morning lasts about 1 hours; my symptoms are actually worse once I lay down at night to go to sleep.  The fingers, wrist, arm stuff gets worse with activity.  Hubby and I have been testing recliners for the last few days--ouchie!

OK,  I don't have any kind of tests to bring to this appointment, since I just called my primary care's office and told them I wanted a referral.

Help me make the most of my appointment:  what should I make sure she asks/does/talks about? (I did fill out an extensive patient questionnaire that I am supposed to bring with me).  What tests should she order?  Are they reliable?  Would it be rude of me to ask her if she is the kind of doc that goes stictly by blood test results or does she factor in how I actually feel?

What chances to you think that she could at least give me something at this appointment for the inflammation/acheyness/pains that I am having, before any actual rest results are in?

I think that is all my questions; can you think of anything else that I need in order to go in as an informed, pro-active patient?

Thanks for reading this long post.

--(not so) newcrohnswife

Appointment went well, I think...let me explain...I filled out about 8 pages of questionnaire, symptoms check-off stuff before i even went.  No test were done beforehand as mentioned already.  She went over everything, plus asked for more details.  I guess because of what I've been going through with hubby and crohn's, I've got things documented out the whaaazooo.

She then did an examinaation of fingers, hands, wrists, feet, etc.  I had had a blood work-up for my annual checkup back in December and she retrieved those results.  She went on to explain a bit about meds, the importance of catching RA early, and how well it can be treated in someone "young" like me (43). 

She put me on methotrexate (sp?) told me to start today; it's a low dose apparently (4 2.5 mg pills a week) and naproxyn (sp?).  Said to get bloodwork done after 3rd dose of the methotrexate.

She said that she could do bloodwork first, which could come back neg; but she also treats based on "obvious" clinical observations, which she felt I had.  She says that RA factor could take a year after symptoms show up to actually be elevated, anyone heard that before?

Told boss how things went.  He seemed a bit suprised that she dx'd RA, he said that he would have leaned towared osteo....I told him that there were some things going on since we had last talked (and he told me to get seen).  Then he concurred.

So, she feels based on her examination and my detailed descriptions (with family history) that it is RA.  I will take my first dose of methotrexate tonight; she says to not start the naproxyn for a few days after that.

What do you think of that?  There's probably some things I left out, but my hands are killing me.  Off to just read about these drugs...

--newcrohnswife

Hi and thanks again.  She did mention something about folic acid, but didn't say to take any...wish I had paid attention a little better on that one.  What is the reason for the folic acid?  She did ask me if I ate lots of leafy greens, which I do.

Took the first dose of meth. last night about 1 hour before bed; felt whoosie for a while before falling asleep, I guess that is normal?

Oh, and I can't beleive I forgot this in my last post: pharmacy would not fill the naproxyn script they said it interacts with the methotrexate.  And in the patient information sheet that you get with your script, sure enough it talked about that....

Why would she give me that then?  She did say something about since we don't need to be concerned about stomach ulers in me that it would be OK.  At least I think that's what she said.  Anyway, pharmacy was waiting for a call back from doc before filling it.  Since she had said to wait a few days after the methotrexate to start that, I didn't make a big deal out of it.

OH---I remember now.  She said something about getting sores in my mouth, and if that happened then we would do folic acid!!!  So, should I just take some anyway?  I really would rather not wait to see if I get SORES in my mouth....

--newcrohnswife

How do I tell if the amount of folic acid isn't enough? The mouth sores?

When you say "drink more water than you normally would"--OK, I normally drink nearly a gallon of water a day!  Should I drink  more than *I* normally would, or more than most people probably would?

I don't feel overly tired today; no headache either.  These are what I see can most commonly happen; so other than feeling a bit queezy last night, so far, so good.

--newcrohnswife

Thanks so much for your help!  I think I might just take some folic acid anyway...

I would rather NOT wait till sores show up, as I don't need something else to deal with!

Again, thanks for the help on this thread.

--newcrohnswife