FWIW: A Second Opinion | Arthritis Information
I've lurked for months and am only now posting. It's been a wealth of information and support. Am 44 year old male, father of 3 and workahaulic (40-hour job, and 3 seperate side enterprises). I was diagnosed with RA 3 years ago, and it's been a physical and emotional roller coaster: aches, pains, meds, doctor visits, arthoscopic knee surgery, blood samples, tuberculosis test, lab work, eye exams, xrays, aspirations, flare-ups with/without fever. At times - acute pain, swelling, stiffness of wrists, fingers, hands, knees, elbows, ankle, feet (mostly wrists, but any single or combination possible), but always aches, pains, limps, stiffness. I've nearly completely depleted years of accumulated sick leave at the "real job" and am oftentimes unable to perform my work duties (except telephone and delegation of admin duties in side jobs).
Meds taken include (no particluar order and am sure I'll forget some), usually a cocktail of several: advil, aleve, naproxene, sufazine, vioxx (back in the good ol days, way before RA diagnosis and when it was available), mobic, colchicine, indomethicin, celebrex, plaquenil, methotrexate, enbrel, humira, decadron, methylprednisolone, prednisone, Toradol, cataflam.
Am just coming off a major, 2-week flare-up and am again able to type. Have not been on Enbrel since early June. Am presently taking daily dosages of colchicine, predisone and cataflam and....Uloric.
At the encouragement of a friend/client/doctor, I yesterday consulted the opinion of a second rheumatologist. Long visit, medical history, physical exam, and afterwards, complete blood work and x-rays. His almost immediate diagnosis from 3 years medical (pending current blood work to rule out certain and other conditions): acute polyarticular gout!
This diagnosis was supported by physical exam, presence of tophi in finger and ears, and years of primary RA physicians blood work that are RA negative. Will know for certain in 4 weeks, but everything I can read and learned about tophaceous gout - especially the fact that I was once diagnosed with gout in big toe 15-20 years ago - and the continual progression of this condition - are entirely consistent with what I've experienced. On the one hand, a weight's been lifted; on the other, I'm frustrated, almost angry. In the years I've been misdiagnosed the condition has progressed and could have been quelled (takes 2 years for allipurinol or uloric plus treatment to "fix things"). The costs of time and money alone are discouraging.
Over the years, I've met several people that have wrestled with RA-like ailments and now wonder how many of them, like me, have been mis-diagnosed. If just one reader at this forum is spared the mental and emotional burden of my past 3 years, or receives the neccesary treatment to immediately alleviate their debilitating pain, it will be worth my having posted this.
Thanks and best regards, black (duck) dog
black dog2010-08-24 07:25:53Anyone who shows no imporovement with treatment should seek a second opinion. Anyone who does not fit the "norms" of a diagnosis should seek a second opinion. Anyone who receives a diagnosis of a chronic illness should seek a second opinon.
Because you are absolutely right Black dog...it sucks to have a wrong diagnosis. Rheumatic diseases are very difficult to diagnose many have overlapping symptoms so getting another opinion is always a good idea. Be wary of drs who do not do their own diagosing and rely on a previous drs diagnosis.
That is really interesting Black Dog, very much appreciate to your story. I sometimes wonder if my doctors are accurate in diagnosis. Similar conditions to yours I think, but I am newer down the patch of doctors and medicines, only a couple of months.
Can I ask, or do you know the blood tests results? For example, I just looked and my "Rheumtoid Factor blood test has a value of 376. Evidently that is conclusive for RA, but I don't yet understand how accurate this test is.
Roland
I do not know the numbers but will try to find out. I do know that the second opinion Dr said that it was not conclusive, and think I remember the primary saying it was inconclusive but that that alone didn't rule it our. Apointment with each within 4 weeks and am going to hem this thing up, hopefully.I am also a father and have had RA for six years now. I have been moderately fortunate to be able to some of the pain down to manageable levels. It sounds like you have a hard schedule with many demands. I can relate to this, also. Although many disagree with the use of pain-killers, I find that at low levels (1/2 pill) they cut the pain level down to functional levels and allow me to live a fuller life. I take maybe a 1/2 pill or even a 1/4 of pill once or twice a day and then one at night. This plus a few well scheduled catnaps and I can work and play and keep going. The dopiness of using them wares of rather quick and you are able to go thru life just fine. Its just an option that did not seem to show up on your list of meds. They are not for everyone, but you may want to have a discussion with your RA doc or your GP. Good Luck.Follow up to the first post above.
Am very glad I went and got a second opinion! The new physician reported the following yesterday: 2 differents blood tests (which I understood him to say were "old" and "new" kinds of tests) were not RA indicative. SEDS was good, no inflamation. Absolutely no basis whatsoever for RA diagnosis.
What started with a few inflammatory and painful maladies many years ago (monoarticular gout) spread into many joints (polyarticular gout). Nodule on elbow, typhous-induced swelling of fingers, pain in knees, ankles, wrists, elbows. During extreme flare-ups, slight fevers, aching muscles.
Th good news - not RA, and the Uloric has decreased uric acid levels to good range; the tophi will metabolize and go away. The bad news, YEARS of freaking misdiagnosis, tests, tests, tests and drugs plaquenil, humira, enbrel, methotraxate, etc., from a rheumatologist that is supposedly one of the very best in the state! Had pharmacuetical therapy for gout been initiated 2 or 3 years ago, I'd have metabolized existing typhii crystals, avoided knee surgery, and remained productive during the many, many flare-ups.
Second opinions from now on. Never again will I not improve and accept a single expert opinion! Good luck and best regards to all.
Welcome Black Dog, thank you for posting your experience. It has given me a lot of food for thought.
Thank you for posting the importance of getting second opinions.
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