sort of good, sort of bad

daffy2

Had a GP appointment today to discuss OA situation, as I'm still worried by the speed with which it seems to be progressing. Conclusion was that as far as she could see from the various blood test and xray reports,questions I've asked, questions she's asked, there isn't any reason as such for what's happening so no treatment options other than the usual pain/inflam meds, but possibly try using them differently to see if that helps. I rather thought that would be the case, and part of me is not sorry as I don't have a good track record of drug tolerance and so something that had to be treated would have been a worry. What's still a worry is the rate at which I'm growing bony lumps and bumps, especially on my fingers which are beginning to be adversely affected by them.
On the plus side(hopefully) it looks as if the GP may have been able to get past the barrier put up by the awful Orthopaedic Triage appointment I had last year regarding my back issues, as I've had a letter from something called 'Referral Management Team' (cynic in me says that it's their job to block access to consultants...) saying that I am to have an outpatient appointment with a consultant - doesn't say what sort, but at least it's a bit further up the chain than a 'GP with an interest in orthopaedics' !

dreamdaisy

I can see why that was a curate's egg of an appointment. Arthritis will do what it wants to do when it wants to do it, as those of us who have it properly know to our cost. I'm not sure why using the meds in a different way might help but who knows until you try? Have they definitely ruled out an auto-immune kind rumbling away underneath the OA? I feel I should remember this but I don't - I am sorry. :oops: DD

daffy2

In due course I'll do some more investigation, as I'm still wondering about auto-immune issues given other things that have happened over the same period, but at present the obvious things have been ruled out - I have asked about sero-neg - and the various recent xrays and hand scan haven't given any cause to think it's not 'just' OA apparently.
The thinking about the drugs is perhaps try taking them as a short 'course' to knock an inflammation episode, rather than just the one to take the edge off which is what I do currently, as it seems possible that one reason why it has progressed so quickly is the inflammatory aspect, which is being increasingly recognised as important in OA. The GP reckons it might be worth a try, and wants me to keep track of how it goes as obviously long(er) term use will bring its own considerations(stomach protectors versus OP....)

stickywicket

I hope the orthopaedic(?) appoitment comes through sooner rather than later. What, ideally, would you like to come of it, daffy? Orthopaedics have been good to me in the knee and hip department and usefully informative in hands and feet but backs are a bit more tricky things and I think that's your worst bit. (Am I right?) At least the ball is in motion.

As for the lumps and bumps – mine are mostly well-established now but, insofar as I can remember, I've a feeling they tended to arrive en masse after a certain point. Maybe that's what yours are doing ie it's not necessarily getting worse just arriving at a point where these things emerge. That, in case you hadn't worked it out, is me looking on the bright side. If I'm going too Pollyannaish just tell me

Stomach protectors v Osteoporosis? I do both. I don't recommend hurling towards broken bones but neither do I waste time agonising over what must be. Sometimes the choice is between bad and worse. I console myself that I mightn't live long enough to get the broken bones

daffy2

Yes Sticky it is my back I want to get an orthopod view on. My reasoning is that without some form of 'baseline' then assessing what's happening/changing over time is going to be problematic. The one good thing that came out of last year's appt was that I had a spine xray ( which coincidentally showed up the arthritis there as well), the first since I was diagnosed with scoliosis 45 years ago. Quite a lot has happened in the intervening decades and the OP and OA diagnoses of the last 3 years mean that I feel I need as much info as possible in order to try and manage my back problems in the coming years - after all I can't see it! It would be good to have an informed and informative exchange with a suitably experienced medic, but I suspect that may not happen, so I'll settle for the facts. The state of my back also has a bearing on things like my knees etc as well so even more reason to be as well informed as possible.
Interesting thought about the lumps and bumps - perhaps that's why the interior joint workings are apparently not too bad according to the various xrays? It's all happening on the outside. In which case, on balance, the lesser of two evils possibly.
And no, you're not going too Pollyanna-ish.

stickywicket

Yes. I can see that, with OA, scoliosis and osteoporosis going on there, you'll want to know how things are progressing – or, hopefully, not. I hope you get a helpful consultant. Mine have mostly been brilliant but there's always the odd one who is less than useful. Luckily, for me at least, they've been the exceptions.

daffy2

I'd wanted to do this last year, but there's added impetus now as it's apparent that something has changed in recent months. When I came to start wearing my summer clothes I thought at first I'd put on weight as things were very tight around the waist and rib cage and I seemed to have acquired a noticeable pot belly. Checking with the scales(which I had to buy as I didn't have any) showed no weight change or a very slight loss, but looking in the full length mirror showed that I was much more twisted/lopsided. The increase in pain and discomfort from my back I had until then explained away with gardening etc.Fortunately my GP didn't try and dismiss my concerns and in fact asked for some info I'd got from the scoliosis charity to support her request for a referral for me.
I don't feel it would be sensible to look into manipulation/physio/exercise to try and help with that until I know what is going on. In the meantime I'll go back to what I know might help but won't make anything worse - I've become rather lax about some simple things I could be doing regularly, as one does when life gets in the way...

stickywicket

I like your GP.

I used to have one who, when asked a question, never ever waffled but just said "I don't know. Let's look it up." I had every confidence in him.

Oh yes, the simple basics which we easily let go of. Tell me about it.

daffy2

If more GPs had the courage - or humility - to say 'I don't know' I suspect many patients would have better outcomes. As DD regularly points out they are General Practitioners so it's unrealistic to expect them to know everything, but sometimes one wonders if the GP is aware of that.

LignumVitae

Bizarre isn't it? I too love a GP who says 'I don't know'. They're much more fun than the ones who start to spout stuff which I know is incorrect! I hope things get known soon though for you (((())))

stickywicket

I'm not sure. I much prefer it myself but I think some people – usually those who know very little of ill-health – go to their GP expecting to be cured almost instantly of whatever they might have. The idea that some things are complex and GPs merely fallible human beings doesn't come into it.

daffy2

As always it depends on the individual. Those of us here are probably, by virtue of our condition(s), more likely to engage in discussion with the GP. There are many patients though who either can't, or don't want to, do so and want the GP to advise or make decisions. That's why I said many rather than most. Such is the power of the human mind that a patient with confidence in the GP might do as well with less than 'perfect' advice or treatment as one who has engaged in more depth in the decision process.
And as you say Sticky there are those who simply expect the occasional ill-health interruption to their life to be sorted by the GP, in the same way the garage fixes their car.