Confused

MUM1

I was diagnosed with OA (by physio) 41/2 ago. I also have carpal tunnel syndrome. I had it when I was having my youngest son 15 years ago then it dissapeared only to come back 2 years ago but now get more pain in my middle finger and an ache up my forearm. I also had psoriasis from the age of ten till my mid 20's(genetically inherited from my dad and my sister has it too), I had a bad throat infection leading to bed rest and being on antibiotics which caused the psoriasis to flare up badly,red burning scaley patches and when undressing what I would liken to very bad dandruff falling onto the carpet (drs now say I am allergic to penicilen). I was given oilatum and I think the name of the shampoo was polytar( it was in a brown bottle). The medications for the psoriasis were helping slowly but a friend suggested I use her sunbed (for very short periods of time along with approval of dr on that basis) and since then have had no evidence of psoriasis. What I would like to know if anyone can help is carpal tunnel related to OA or RA and although I no longer have psoriasis or any evidence of it is there any chance I could have been wrongly diagnosed. I also seem to be quite chesty or have the cold often. I have had 2 chest infections this year, the latest one I have had since september after my hysterectomy in august I have had 2 seperate lots of antibiotics doxycycline and clarithomycin but don't want to bother the dr again as when my chest was last checked they said it was clear. Any help or advice would be much appreciated. thanks

MUM1

MUM1 wrote:

I was diagnosed with OA (by physio) 41/2 ago. I also have carpal tunnel syndrome. I had it when I was having my youngest son 15 years ago then it dissapeared only to come back 2 years ago but now get more pain in my middle finger and an ache up my forearm. I also had psoriasis from the age of ten till my mid 20's(genetically inherited from my dad and my sister has it too), I had a bad throat infection leading to bed rest and being on antibiotics which caused the psoriasis to flare up badly,red burning scaley patches and when undressing what I would liken to very bad dandruff falling onto the carpet (drs now say I am allergic to penicilen). I was given oilatum and I think the name of the shampoo was polytar( it was in a brown bottle). The medications for the psoriasis were helping slowly but a friend suggested I use her sunbed (for very short periods of time along with approval of dr on that basis) and since then have had no evidence of psoriasis. What I would like to know if anyone can help is carpal tunnel related to OA or RA and although I no longer have psoriasis or any evidence of it is there any chance I could have been wrongly diagnosed. I also seem to be quite chesty or have the cold often. I have had 2 chest infections this year, the latest one I have had since september after my hysterectomy in august I have had 2 seperate lots of antibiotics doxycycline and clarithomycin but don't want to bother the dr again as when my chest was last checked they said it was clear. Any help or advice would be much appreciated. thanks

I also forgot to say I have had 3 stomache upsets since september 2 with vomiting and asked dr if it was co-codamol or diclofenac causing this and he says he thinks it may be the winter bug.

LignumVitae

Hello Mum1

It sounds like you have an awful lot to contend with there. I can't help very much but I am sure somebody will be along soon who can offer more advice and help than I. I did want to just say that I have suffered stomach problems associated with both diclofenac and one of the formulations of co-codamol but I think the symptoms tend to get worse rather than come and go (I could be wrong with that though). As for not wanting to bother the GP again, it does sound as if you need some proper help and care to get things sorted so I think maybe you should bother the GP again and maybe see what chances there are for getting a referral on to a specialist, possibly a rheumatologist as you don't mention seeing one of those or of any blood tests etc that have been carried out to help diagnose your symptoms. There are over 200 forms of arthritis, with many symptoms overlapping, equally, there are lots of other ailments that have characteristics similar to arthritis. It's a bit of a minefield and it did take me nearly 10 years to get a diagnosis or sorts.

Good luck and let us know how you get on
LV

dreamdaisy

UV treatment is known to help clear psoriasis (my neighbour used to go to the hospital every fortnight for controlled exposure) but too much can lead to different problems - it's best to keep it to a minimum. The psoriais hasn't been 'cured' as such (it's an auto-immune condition) but it can lead to psoriatic arthritis: my label changed from an 'inflammatory arthritis' to PsA when my skin helpfully obliged with a bout of P, now my daily sulphasalazine helps to keep it at bay but it's constant on my ankles.

Carpal tunnel isn't directly related to either OA or RA, it has a number of different causes (pregnancy being one of them as you have discovered). I had very bad CT (triggered by arthritic hands) and had both hands done last November. All of that has cleared but the arthritis in my wrists and fingers has been a real bother since the op - sometimes you just can't win. :roll:

As for the infections it is very easy to catch bugs and not so easy to get over them. I am rigorous with hand washing and sanitizer, I take wipes with me everywhere I go and I'm not afraid to use 'em in public! We do have to navigate our way along a very tricky tightrope from time to time and this would seem to be one of those times for you. I wish you well. DD

chookgate

diclofenac can definitely cause stomach upset - it is a well known symptom, and often doctor's will prescribe something else to protect the stomach when you are taking it.

Sounds like your GP is a bit like mine - visit them once and they tell you it's nothing, so you feel like a nuisance going back, but they are just putting off getting to the bottom of the problem. They actually expect you to go back if the symptoms don't go away - so keep going back until you get on the mend.

Carpal tunnel syndrome is caused by compression of the carpal tunnel, as Dreamdaisy said that has many causes, but one of them is arthritis which could cause bone growth to press on it.

MUM1

Thanks for the replies everyone.I spoke to dr a few weeks ago about stomache protector as pharmacist had said it might be a good idea owing to the fact that I had been taking them on a regular basis for about 2 years but dr said unless i had any symptoms I needn't worry yet and yes you do feel like they are putting off getting to the bottom of the problem I am ususaly sent away with more co-codamol & diclofenac and if it's worse tramadol, I have also been reffered for physio twice in the last four years the first physio I saw was the one who said I had osteoarhtritis (wear and tear) but no mention of rheumy or scans etc. One gp sent some bloods away a few years ago she mentioned something about the fluids, I'm assuming she meant around the joints, they came back clear. The carpal tunnel I first had it 15 years ago when pregnant with my youngest i used wrist splints then and somtimes cry with the pain, it dissapeared after he was born only to return 2 years ago sometimes it can be quite painfull but not yet to the extent that I would be crying, painfull enough to wake me in the night, although I now experience pain in my middle finger as though my joints feel sore and also like an aching pain in my forearm. It would be nice to know exactly what I am dealing with so that I can try and cope with things better and keep myself as healthy as I can as my oh has COPD as well as RA.

stickywicket

I don't know if it's already been said but rheumatologists deal with auto-immune versions of arthritis while GP's deal with OA. If yours is definitely OA you won't be sent to a rheumatologist. If you're worried that it might be an auto-immune form, you can ask your GP to refer you to a rheumatologist.

As for the anti-inflamms, having suffered permanent damage from them in my early arthritic years I've always suggested a stomach protector to anyone taking them.

MUM1

Hi stickywicket thanks for your reply. As I said in my last post it was the first physio I saw 41/2 years ago said that it was OA and although I had psoriasis from the age of ten till my mid twenty's due to getting a bad throat infection and not sure if it was that or penicilin that triggered a very bad flare up of my psoriasis I used a sunbed for a few minutes at a time along with the polytar shampoo and oilatum my psoriasis seemed to be cured as there was no physical evidence ie dry scaly patches etc. I then wondered if it was in fact some other form of arthritis. I am due to see physio again in the middle of january would it be a good idea to talk to her or my gp or would they know that I had psoriasis from my medical records anyway.

barbara12

Hi MUM1
Sorry I cant help, but I just want to say I hope you get the help you need very soon, just a point I have OA and I have twice seen a rheumy just to make sure nothing else is going on along side the OA. xx

stickywicket

Ah now here's where I can help, MUM1. Never, ever, assume any medical person will pick something up from your notes. Your notes (well, mine) run into several volumes and your doc's patients are many and varied. Think how many people he sees in one day alone.

Even when they remember your face, they will not remember all that has ever gone wrong and certainly not all that you have ever told them. I remind mine - GP, rheumatologist, ortho surgeon - , every time, of anything I think may be relevant.

If you have a good relationship with your physio then do discuss it with her but it will still be up to you to see your GP. If you're nattered that you might have PsA then your GP should be made aware of the family psoriasis factor.

MUM1

Thanks for your reply stickywicket. I think the better option would be to speak to one of the gp's at my surgery who is a good listener as it will be a different physio I will see from the one I saw in december. Do you know if psoriasis can lie dormant for years and still be in your system as I have not had any flakey patches etc as I said since my mid 20's (about 26) and I'm now 48. At worst I may get some irritation (blistered, weeping then very dry skin) through using something like say powdered rubber gloves and surf soap powder was another but now know to avoid those I also get quite bad prickly heat rash when in the sun even with the use of sun cream and trying to stay in the shade so out comes the antihistamine cream ( this is something i have only experienced in about the last 3 years but rears its ugly head every year now) It can get quite bad on my arms( the rash is so raised they feel like a toads skin :roll: but I also get it on my upper chest and legs if wearing 3/4 length trousers. It will usually appear within hours and can take up to a couple of weeks to dissapear.

dreamdaisy

Psoriasis is an auto-immune skin condition so yes, it's always there: dormant maybe but still a presence. The meds suppress mine but it's always on my ankles. DD

MUM1

Thanks dreamdaisy so that would maybe explain why my skin may be sensitive to the sun. I do wear sun cream normally factor 30 and try to keep in the shade but never works well and then have to resort to the fenistil gel.

dreamdaisy

I was riddled with eczema when a child, the psoriasis appeared when I was 39 and now the meth makes me even more sun-sensitive. Sunny days mean trousers, socks, long sleeves, a scarf for the back of the neck and a hat even with my applying sunscreen (add greasy clothes to that sad little list). Ain't life grand?

MUM1

Isn't it just Dreamdaisy. I have good/bad days/weeks (like most of you on forum). This week wasn't too bad maybe the milder weather, and I am managing to get by on 2 out of 3 diclofenac and 4 30/500mg co- codamol a day at the moment. A dose before I go to work and then one at bedtime, though hip has started to get a bit sore again maybe with it turning colder again, end of nov and most of dec I was getting quite bad pain going from my hip (like a spasm) and sharp pain running down to my knee and a few times my leg felt as though it was going to give way (was crying like a baby a couple of times), but managed to get through the weeks of limping at work. I had hoped after my hysterectomy in august that I could possibly look at going back to work full time at some point but deep down I know it's probably not going to happen now as my arthritis seems to get worse with each passing winter. I still get pain in summer but it's not qiute as bad.

Mat48

Hi Mum1. I read this thread with some interest. Like Dreamdaisy I suffered from awful eczema as a child and then right through adulthood until about five years ago - around the time when my menopause started and at the same time as our cat died (and no replacement) and I stopped working with oil paint (I'm an artist). So I had five good years without skin problems and then my joint pains began.

I was diagnosed just over a year ago with RA having been referred to a rheumy consultant by my GP because of high inflammatory markers and a low positive Rheumatoid Factor. Since then I have been on two disease modifying drugs and am doing quite well now with little pain apart from lower backache which I'm told isn't RA. However it often occurs to me that I've been misdiagnosed - I'm not sure why exactly because until recently my inflammatory markers were still high and then I switched to Methotrexate by injection and they have come down a lot (still elevated though). My right hand has some deformity and my fingers have drifted a little and my knuckles are still a bit swollen - which corresponds with RA.

My consultant wrote (and said when he diagnosed me too) that for now this was a working diagnosis of RA but things might change and we should keep an open mind. At first I stupidly (false optimism) took this to mean that it might be a post viral arthritis still and just clear off. But recently I have realised that he meant that with my history of skin problems and other auto immune issues it might turn out to be PsA. So I have researched this sister condition and although it usually manifests itself by the presence of psoriasis first - the arthritis can come first sometimes and the psoriasis follow - and occasionally a person can have PsA without any outward sign of psoriasis.

One of the main things that distinguishes the Spondyloarthritis family from RA is that it almost invariably comes with a family history of Psoriasis or PsA - whereas the jury is still out on whether RA is hereditary. So if you have a family history of psoriasis or PsA and if you have pitted nails or other nail deformities or if your psoriasis comes and goes (and I don't think sun/ heat rashes count - they are more akin to eczema) then there is some chance this might be PsA as you have a history of this already. But as DD and others have said you can have both OA and PsA - and OA can be very aggressive and painful too - but unlike PsA or RA it doesn't respond to DMARDs and isn't systemic in the same way.

As Sticky Wicket says I certainly don't think you should assume that anyone in your healthcare team will remember that you have psoriasis or will make that connection without you pointing it out. Your GP is the person to go to because only he or she can refer you to a rheumatologist to rule out or diagnose PsA. Hope this helps a bit. Mat

PS a friend who suffers from RA and OA said that the main difference in pain is this heat in the joints with RA and a feeling as if something were burning and eating at their joint whereas OA is more just straightforward joint pain and doesn't burn or feel acidic and isn't as weird. Not sure about PsA but I imagine it's more like RA.