2nd Rheumy appointment today

shazzie39 · 18. May 2010, 05:15

Just wondering if the second appointment is like the first?

First appointment I got weighed blood pressure tested asked for a urine sample. Then went into see the Specialist and he took a history of symtoms and did a physical examination. I then got sent for bloods and xrays on my hands and feet (Not my shoulders knees elbows which are my biggest problem areas). I was then given the diagnosis of R/A. THEN ..phew... I was taken by the nurses and injected with several steroid injections... for someone who hates needles this was very stressful....until the nurse started that is.... she was great. She could have given me 100 of these she was so gentle. I was started on MTX and given a load of blood forms. 7 Weeks on here I am waiting for MTX to work. In dire need of some effective painrelief (Can the Rheumy help with this or do I have to go back to the GP? :? )
The steroid injections didn't last very long

If my understanding is right I cant have anymore today? mmmm ..If that is the case then my knees are in real trouble and my arms too. I cant lift the quilt off myself in the mornings or get up out of bed without my OH. Or get in and out of the bath for that matter ooowww.

Love
Shazzie

dreamdaisy · 18. May 2010, 05:33

Not sure I can help here: I too have had steroid injections, they are meant to last up to three months but I found about three days was the limit. You are not allowed any more within a three-month period.
I now use oral steroids which improve things, but I am well aware it is a fake effect.

I have injected meth and it does nothing. It is there to support the humira which I am currently on, and the humira has made all the difference, not the meth. The same drugs work in different ways on different people. For some it has led to a whole new life. For others it has reduced pain and inflammation. For me, zilch.

The rheumatology nurse can discuss pain relief but I'm not sure if she could prescribe anything. Your GP may be a better port of call.

I haven't had a bath since 1997. I can manage (just) in a shower, that's enough. Good luck with it all. DD

shazzie39 · 18. May 2010, 05:52

Thanks DD. I hope today the review will at least give some hope of this R/A being controlled even if I cant feel it yet. Humira - is that an anti-TNF (newer drug?). I was looking at some of the posts on this drug and it appears to have more positive results than negative ones. I might well mention this today to Rheumy and see if I am a candidate for it. I am not sure how long MTX alone takes to work. Some lit. says 4/6 Weeks others say up to 12 weeks.
What I am learning fast is that it can be a bit of a minefield to navigate treatment that works. I am not known for my patience heheheh and always lived life at a pretty fast pace. R/A has slowed me down to a snails pace. I would be content to be at least back to a jogging speed! (Wouldn't we all!)
Thanks
Shazzie
x

dreamdaisy · 18. May 2010, 06:15

Humira is an anti TNF but one is not usually allowed onto these until a number of other treatments have been tried and failed. All arthritis drugs come with standard advice about how long they may take to start working - 2-12 weeeks is the norm. They also take up to 12 weeks to clear the system when you are taken off them.

Meth and sulphasalazine are the usual starter meds. I have PA and the sulph at least keeps the P bit of that at bay, not that I've had a major problem with it to date (sorry, PA is psoriatic arthritis, P is psoriasis.) You may also be put onto an anti-inflammatory such as naproxen.

This is a roundabout that, once you are on, you never get off. I'm still a novice at all of this (I began PA in 1997 but no-one knew what it was, I wasn't officially diagnosed until Oct 2006). It is trial and error all the way, for all of us. What works for one person does nothing for another. I have now learned to start each new treatment with no expectations of anything. That way I don't disappointed. DD

shazzie39 · 18. May 2010, 06:34

Oddly enough a colleuage of mine suffers from P/A. I have had mild bouts of psoriosis since the age of 15 the worse attack came 3 years ago where my legs from the knees to the ankles were plastered. This cleared up after 3 months. I would have put money on the diagnosis being P/A but the Rheumy said he is leaning towards R/A despite my history. My Nan suffered R/A so there is also history with this too. Another trigger which seems common to some sufferers of Arthritis seems to be an infection. Last Oct I was prescibed Ibrufin for what was thought to be a frozen shoulder. In Dec I was hit by a massive and violent gastro infection and was given treatment for a stomach ulcer. This took until Feb to clear up with Lanzoprasol. My R/A symtoms started 10th Feb (I remember this because I had an x ray on my shoulder that same day! irony!) I think this is why anti-inflam drugs have not been offered to help with the symtoms. I will ask today if there are some anti-inflams that I can be prescibed that wont cause or aggravate the stomach. This may at least relieve the swelling in my fingers and knuckle joints and may help with my arms in the mornings! I would love to be able to move in bed without the agony!

Cheers
Shazzie

dreamdaisy · 18. May 2010, 06:54

You sound like a classic PA to me. I've only had two bouts of psoriasis - 1997-1998 when it was on my scalp and Oct2006-Feb2007 when it was on the palms of my hands and the soles of my feet. Only then was the skin problem diagnosed. I currently have a very small patch on the inside of my left ankle. I do, however, have a life-long history of eczema.

PA and RA present in extremely similar ways, but RA can be diagnosed by a blood test (though not always) and PA cannot. Your history of psoriasis would point me in that direction - PA usually begins in the small joints and moves to the larger ones, so toes and fingers are affected first. I did it completely the other way round, left knee, followed six years later by right knee, followed three years after that by right ankle, and now, all in a rush, hands, feet, wrists, left ankle, shoulders and neck. Whatever it is, the teatment is the same. DD

tillytop · 18. May 2010, 17:21

Hi Shazzie - hope your appt went well today and that you have now got a prescription for some effective pain relief to tide you over until the mtx starts to work. I am surprised that, after the steroid injections, you were left without anything except paracetamol - which is obviously not going to make much of a dent in your RA pain!
Maybe you will be able to have some oral steroids which I have found can make a big diff very quickly. Or some stronger painkillers. Over time you may find, like me, that you build up quite a "stash" of prescription meds and you will get to know what you can take when you need a pain relief boost. (I'm currently working my way through last year's prescription valium. Helps me to sleep and I don't have to go back to my GP!). Anyway, hope it went well today - and please post an update to let us know how you got on. Love Tilly x

skezier · 19. May 2010, 01:24

Hi Shazzie,

Glad you found the forum.

I hope it goes well and back along now but I think my second appointment was fairly similar except he then started treatment and gave a diagnosis. He has added to that one a bit ever since

Steroid jabs are a grey area and clearly don't have an overall number. I think Rumo's and pain clinics have their own systems for both drugs and jabs - they do as many on me as I need it seems. Last year I had my neck done with the big injections (they use both medron an cortisone as well a chemical in that) 2x, trigger points of cortisone every 9 weeks and also 3 into my knees and elbows. I can't really do maths and also be honest I have lost count of how many too. So far I am running on less this year but I honestly think its a case of how well it responds and what individual consultants think.

How long they last is a bit like a bit of string. Some of mine do last very well and others are not so good but all of them help even if only for a week so I am kinda lucky.

Good luck and fingers crossed they will have narrowed it down and will start some treatment for you as well. Nice to meet you. Cris x

shazzie39 · 19. May 2010, 03:31

Hi Cris
Nice to meet you. Thanks for the post

.
It was all a bit strange yesterday. I have taken MTX for 7 weeks at 15mg for the last 3 Weeks. This hasn't yet had any effect at all. I asked him what more could be done to control the pain and swelling, bearing in mind I was told to use paracetamol by my GP. Rheumy thought I was on Anti-inflams already!!! He had my notes from the first appointment to show what I was taking and yet I have gone 7 weeks without anything to help the symtoms. Sorry this has turned into a bit of a rant :oops: Anyway it will be resolved now. He is writing to my GP with a list of anti inflams pain killers and stomach tabs (prone to ulcers) and I should have these next Wed. Roll on

As for the injections, of the 6 they did 7 weeks ago, only 2 have held out. The knee and left hand knuckles. The shoulders and elbows lasted about 3/4 days but like you say this was better than no pain relief

Thanks for letting me waffle.

Cheers
Shazzie x

dorcas · 19. May 2010, 03:54

Hi Shazzie and nice to meet you.

Our experience of rheummys seem to be as varied as arther itself. :roll:

I'm sorry to read that after your first appointment you had been left to cope with pain without having proper meds to reduce the inflammation and analgesics.

that just isn't good enough!

It's really not very reassuring that the rheummy didn't know what meds you were taking but hopefully he has now taken on board what you need and your doc will prescribe you effective meds.

Did he give you steroids this time? I get 120mg IM steroids every 6weeks just now ( to try to keep arther under control until after my next op.) so it is possible (as Cris also said) to have steroid jabs more frequently when needs be.
The IM steroid jabs are given when arther is rampaging through lots of joints... it has a more widespread effect than single joint injections...and the steroid is usually in a larger dose too.

Hope you now get better treatment and arther is soon brought under control.

Iris x

shazzie39 · 21. May 2010, 04:21

Thanks and hugs to you all for being so supportive. It really makes a difference.

Wed cant come quick enough to get hold of some proper pain relief. I now have the added complication of my poor son having Chicken pox. Bless him too. He is only 4 and cant understand why he cant go to Nursery and out to play. Sounds daft but I have had to get myself moving quicker to look after him. I am less stiff today which is a bonus

Looking forward to better times :P

Love
Shazzie
x

2nd Rheumy appointment today

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