quarterly RD visit on Saturday

Hi all

Well I forgot all about having an appt. this coming Saturday until they called to confirm it.

Haven't been feeling too good since early June. All my joints feel tender yet if he asks me (as he always does) on a scale from 1 to 10 what is it? I HATE that question. For me pain is either bearable (meaning I go to work every day and take Advil or nothing) to unbearable which I equate with my onset pain that rendered me an invalid for months and not even oxycontin touched. I never know what to say.

Then he will ask if its tender at rest or with movement. Well more with movement but I have a very mentally challenging job all day so I really can't think about how my body feels if I'm still.

Do you have morning stiffness? Well...I do but its minimal- again I compare to my onset days when my body parts didn't even move properly but I had a lot of swelling at the time too. So I'll say not really.

Can you sleep? Yes- in fact I've been going to bed an hr. earlier and still tired.

Do you still work your two jobs? Yes I have no choice to shoulder on and do what needs to be done.

Then he'll look at my hands and feet for deformity- none.

Then he will say I see no sign of any RA activity- see you in 3 months!

That's what gets me. I'm fine with him keeping me off the medicine because it's so toxic and the risks outweigh the need. But to say he sees no sign of RA activity when I'm tender every day & tired just makes me feel bad. I just want some validation.

I kind of feel like all I do is complain when I go for these check ups.

Maybe I should just say- I'm fine see you in 3 months?

I know. People are probably tired of my same old story- I was reluctant to even post.
For some reason I feel indebted to this man who when I was in a very bad place was able to turn my condition around. Maybe it was just time to turn the corner? I don't know but I had a terrible RD before him who did not want to be questioned, who triple booked her appts., refused to give me adequate pain meds and was unable to get my RA under control.
I think the problem lies with how bad I started out and how I am now completely functional. The pain I find bearable to others might not be. The things that I continue to do because of my drive others may not do so he dismisses my symptoms. I don't know what I want for him anyway. I guess I just want him to say- yes sounds like you are in a bit of a flare- don't think we need to put you back on MTX however. I hate the phrase- I see no RA activity.

I believe that with RA there is far more at play than simply swollen, red joints. I know for myself that stress, metal fuzziness and fatigue are all big factors when I get out of the physical manifestation of the disease.

I am pretty stubborn, if I felt my doctor were not taking my disease symptoms seriously I would get a copy of my file and start looking for another doc. I have been blessed with a Doctor that has never made me think this however.

I wonder if you have some other issue at play like B or D vitamin levels. Its worth inquiring about. I had low B levels for quite a while and needed to have shots to boost it up a bit.

I hope that you feel better. -Don

Hey Char,

It was a better visit than what I expected. Sometimes I think I get the result I get by how I explain things.
Dr. was very chatty. I have to say that he loves his profession and not just the rheumatology he specializes in. Back in the day he was your normal GP who also specialized in rheumatology. So he loves taking the whole history at each exam and touches base about everything, cardiovascular, neurology, thyroid, etc....
So when I mentioned having lost my sense of smell yet getting it back briefly when prescribed steroid nasal spray and having it when I was on the high doses of prednisone he took copious notes, looked up my nose and said I have a deviated septum that may be causing part of the problem but that an ENT and allergist could probably help me out.
My main rheumatology complaints were I have been feeling so tired I've been going to bed an hr. early but I'm still tired. Yet when he asked if my fatigue was mild moderate or severe I said mild.
My joints have been tender all over since June. I rated my pain as a 5. Especially my elbows and hands when I do my lunch break walk. I answered no to warm, red joints. My stiffness has increased to be like 30 mins. in the AM. he said that is the top of normal for osteo arthritis. (? that I don't have)
I told him I can't do certain exercises like push ups because my wrists hurt too bad. He moved my wrists around and said the right wrist has only 60% mobility and the left has 80%. he suggested trying them on my fists.
Overall he did not recommend any medication except Cymbalta which he has offered the last 2 times. He said of course it comes with it's own risks and toxins but it really works well with chronic pain if I want to try it. I declined.
He was most concerned that in 3 months I had lost 3 lbs.- where as I was ecstatic! He was alluding to could it be RA ? But I assured him adding a 30 min walk to my day was finally paying off.
How ever I'm going to start keeping a good log because I think I sugar coated how I feel. My elbows are really tender today and my knee caps feel like someone hit them with a ball pean hammer. I sprayed them down with icy hot and Itake Advil before I go to bed.

thanks for asking!
I c