Rheumatoid arththris concern

concernedson
concernedson Member Posts: 12
My mother (in her 60's) has been experiencing pain around her back and shoulders over recent months, especially in the morning. I suggested to her that she go to the doctors as I was worried that it could be lung cancer. We don't have a great track record for cancer in our family and my mother is a smoker. She had some chest X-Rays and everything came back fine *phew*.

Fast forward to last week and the pain still hadn't gone away. She went to the doctors again, and as her usual doctor wasn't available she saw someone else. This doctor seems sure that she has rheumatoid arththris, and noted that movement in my mothers neck is quite restricted. The doctor pointed out that 3 years ago an unrelated bloodtest my mother had indicated that she was on the borderline for rheumatoid arththris and should've been called back for further tests three months later. My mother was unaware of this finding until now.

She is due to have another bloodtest next week and then a followup appointment. The doctor thinks it likely that this will confirm her suspicion that it's rheumatoid arththris. This whole situation is quite worrying because nobody likes to hear that a loved one may have a condition which could negatively impact the quality of their life. I have a few questions:

1) I looked up some studies and it seems like it's very important to get on Disease modifying anti-rheumatic drugs as soon as possible, in addition to pain meds. IF she is confirmed to have RA is it likely that she will be prescribed both of these, or would she be required to go private to get good treatment?

2) If there anything else she can do at this time to maximise a positive outcome?

I hope I've posted in the right place. I've only just found this all out, so it seemed like a good idea to just say all that I know, and begin to ask questions in a bid to help decrease the downside of this situation. Many thanks.

Comments

  • concernedson
    concernedson Member Posts: 12
    edited 30. Nov -1, 00:00
    3) My mother also has diverticulitis. I hope this doesn't mean that no medication will be suitable for her. Do you have an opinion of this?


    It may be that my questions are too specific and treatment centered, but these are the things going through my mind at present, so I'm putting them here as much for myself really.
  • helpline_team
    helpline_team Posts: 2,779
    edited 30. Nov -1, 00:00
    Hello

    Welcome to Chat to Helplines. We can offer support and information for people living with arthritis and their loved ones but are not medically qualified, so cannot offer medical advice.

    If your mother is experiencing severe pain she can ask the doctors for stronger medication while she is awaiting the results of the tests.

    If the blood tests are not definitive she may need referral to rheumatology for further investigations. Rheumatology are the department who prescribe the disease modifying drugs, some people ask for a one off private referral to the same rheumatolgist who they are due to see on the NHS to speed things up. (This can cost around £200 but ask).

    If instead the x-ray shows osteoarthritis then the treatment route is normally to physiotherapy (and painkillers like paracetamol). Physiotherapy can recommend specialists if people do not respond to treatment.

    You would need to discuss with prescribing doctors if your mother's stomach reacted to any of the medication they recommended, but many of the specialists in this field deal regularly with people with stomach complications.

    If you would like a pack of our supporting information please private message us or email [email protected] and mention the enquiry on chat to helplines.

    I hope that is helpful

    Guy
  • concernedson
    concernedson Member Posts: 12
    edited 30. Nov -1, 00:00
    Thanks for being so thorough. This looks like very useful information and provides a really useful framework for when we know more. I've send an email regarding the supporting information.
  • concernedson
    concernedson Member Posts: 12
    edited 30. Nov -1, 00:00
    I'm probably getting ahead of myself a bit here, but it is Rheumatoid arththris, and an appointment with a Rheumatologist is required, how long would a person typically have to wait on the NHS and privately? I know it's hard to be exact, but a ballpark range might help us with making the right decision.
  • janie68
    janie68 Member Posts: 1,186
    edited 30. Nov -1, 00:00
    Hi

    It depends on where you live, how many consultant rheumatologists there are in your trust, you would be best to ring up the rheumatology dept to get more info on waiting times for your area in the NHS. Then ring your local private hospital and ask them also.

    Janie
  • elnafinn
    elnafinn Member Posts: 7,412
    edited 30. Nov -1, 00:00
    I will say that usually you will get a referral faster if you choose to go private rather than down the NHS route. You are also guaranteed to see the person of your choice and not a member of the team.

    Elna (a member of the forum)
  • concernedson
    concernedson Member Posts: 12
    edited 30. Nov -1, 00:00
    Many thanks to you all for this useful information. She's going for a blood test the middle of next week, and has a follow up appointment with the results the following week.

    I will endevour to find out more about rheumatologist waiting times in the meantime to know for sure whether much time will be saved by going private. I guess this is best brought up at her results appointment, assuming that this certainly is rheumatoid arththris? I can only go on what the doctor said she strongly suspects, and wouldn't want to go private being an official diagnosis, as that could result in time being lost rather than saved. I will keep you all in the loop. Thanks for much for your support.
  • tillytop
    tillytop Member Posts: 3,460
    edited 30. Nov -1, 00:00
    I am a member of the forum, not a helpline member but I saw your message and just wanted to say how lucky your Mum is to have a son who cares so much.

    RA and inflammatory arthritis in general can be tricky to diagnose and, although the GP strongly suspects RA, and the blood test may strengthen his suspicions, blood tests are only part of the picture and cannot, in themselves, confirm or rule out an RA diagnosis. I would therefore hope that the GP would refer your Mother to a rheumatologist based on her symptoms, regardless of what the blood tests show.

    My understanding is that waiting times vary depending on where you live but my recent experience is that my GP has been able to tell me, at the time of referral, what the likely waiting time will be.

    Hope your Mum gets the help she needs very soon.

    Tillyxxx
  • concernedson
    concernedson Member Posts: 12
    edited 30. Nov -1, 00:00
    Update 2nd February

    My Mother received the results of her bloodtest today and on the surface it looks like very good news. As I stated previously a blood test 3 years back revealed that my mother was on the 'borderline' for RA. Apparently the reading was 19 (19 what exactly I'm not sure!). The reading now though is 11 and the doctor says that she doesn't have RA. No followup appointment was proposed and she was prescribed 400mg ibuprofen 3 times daily whenever she's in discomfort.

    My Mother still has neck pain (seemingly somewhat restricted neck movement) and back pain which came on recently, but the doctor said that this is wear and tear. Do you think we should draw a line under this now, or since early treatment for arthritis conditions can help in the longrun, is this worth further exploration? The above poster states the bloodwork doesn't always provide a full picture, so I wouldn't want to just assume everything is okay if it isn't.

    Thanks
  • elnafinn
    elnafinn Member Posts: 7,412
    edited 30. Nov -1, 00:00
    Hi there

    Your mother still has neck and back pain. If she is happy with the diagnosis of wear and tear and can manage the pain/discomfort then that is ok.

    If she feels she cannot then perhaps some further investigations should be done. Has she had xrays or an mri? Wear and tear generally means Osteo Arthritis, or that is how I understand it. With OA the patient is usually prescribed painkillers and anti inflammatories by the GP and if the GP thinks that she should be seen by a consultant then the gp can refer. You could suggest this to the gp should you or your mother feel this may be appropriate. A patient can be referred to a physiotherapist as the gp usually wishes to go down this road too to see if this helps or not.

    Elna x
  • tillytop
    tillytop Member Posts: 3,460
    edited 30. Nov -1, 00:00
    Hello again.

    Just wanted to say that I have just read your latest post but haven't got time to reply now. Will post properlyl tomorrow though.

    Tillyxxx
  • concernedson
    concernedson Member Posts: 12
    edited 30. Nov -1, 00:00
    elnafinn - She did have an X-Ray previously yes, and nothing came up thankfully. I did read that often early arthritis sometimes doesn't show up on Xrays and bloodtests but as I say, the all clear from the bloodtest is positive news. Maybe we should play it by ear. Thanks very much for the reply.

    tillytop - Thanks in advance Tilly :).
  • tillytop
    tillytop Member Posts: 3,460
    edited 30. Nov -1, 00:00
    Hello again - just replying as promised. Sorry for the delay.

    Just a few thoughts...

    Having read your first message again, I just wonder what, other than the previous blood test, made the GP suspect RA? What I mean is, if the GP felt the pattern of other symptoms stongly suggested RA, or an inflammatory joint disease, but has now decided that is not the case, based on the blood tests alone, I would be inclined to request referral to a rheumatologist for further assessment.

    I wonder too, what has led the GP to determine that your mother's pain is "wear and tear" without further investigations and whether it would be appropriate, if a rheumatology referral is not forthcoming, for your mother to ask for an x-ray or scan to see just what is happening.

    You might also like to look at the NICE guidelines for RA, which state the criteria for rheumatology referrals if RA is suspected. I have pasted the link below.

    http://guidance.nice.org.uk/CG79/NICEGuidance/pdf/English

    Good luck with it all and hope your Mum gets a proper diagnosis soon.

    Tillyxxx
  • concernedson
    concernedson Member Posts: 12
    edited 30. Nov -1, 00:00
    Thanks so much for the reply, tillytop. We live in a small town, so I do sometimes wonder if we get as high standard of treatment as elsewhere. The doctor does seem to be making a lot of statements on little information. I guess it's always better to fuller investigate health problems rather than under investigate, so I'll be sure to go over the RA criteria guide with my Mother so she can plan her next move. As you say, it may well be that a rheumatologist is the way to go. That would at least give us a firm idea of whether the doctors initial concern was way off the mark.

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