Hi All,
I'm fairly new here so I will give you a little background info. I was diagnosed in 1991 with fibro. Late last winter/early spring I started having new symptoms that I thought were MS so I went to my family doc with a list and as an aside at the end I told him I also have been having problems with my finger (permanently swollen and SORE). My family doc is not the best but with the severe doctor shortage here (in Canada) he's all I've got. He sent me for x-rays on my hand and they came back as showing "possible erosions". He prescribed diclofenac and I asked to be referred to my old rheumy. By the time I got to see her in September I had swelling and/or pain in fingers, toes on both sides, shoulders and hips . On my first visit she told me I definitely have an inflammatory arthritis but not sure which. She gave me info on MTX, plaquenil, and sulfasalazine and she wanted to see me back in six weeks. She also did blood work. In the meantime, the pain and fatigue were so great that I was forced to quit my job (was a cashier at Wal-Mart). I went back six weeks later and she put my on MTX (20 mg), plaquenil, and kept me on the diclofenac. She said all blood work was fine. She wanted me back in four months.
I went to see her for my third visit last week. I told her that I do think the meds are helping (although not even close to being under control). She said we will keep with it for now and see what happens. I do not go back to see her until September.
I know she is well-respected in her field and I do like her, however, I felt totally rushed and did not get to ask her all I wanted to. I did, however, ask about a definitive diagnosis and she said because my labs are negative she will not call it RA - just an RA-like inflammatory arthritis (although my family doc does say RA).
My question is - how important is it that I get a definite diagnosis? She certainly didn't seem to think it was at all important. I was receiving Unemployment sick benefits (ran out last week) and am seriously considering applying for diability. I know things are different here in Canada but I'm thinking they are going to want a diagnosis. Plus I just feel so in limbo.
Anyway, thanks for listening. I think you all are great.
I do not think it should matter whether it is called inflammatory arthritis or RA. RA is a type of inflammatory arthritis. You have your hand x-rays that show erosions - probably whould show a little better if they were retaken.As far as feeling rushed...do what I do. I make a list of everything I want to ask. Once I'm in the room talking with the doctor, I take that list out so she sees that I have a list of questions. I stay until I have asked eveything on my list.
I don't think it really matters if she's said it's RA specifically...for me anyway. Sounds like she's treating it as RA from the meds she's given you. I know though that we all prefer to have a name to what we have. Just might take some time.
Also, I would say that if you have any concerns before your app't in September, just call her, she'll probably get you in earlier.
Hope the meds work for you Cathy
Kelly
Hi Cathy,
How long has it been since the onset of symptoms? Docs like to wait six months or even a year before "officially" dx RA in patients with seronegative bloodwork. In the US it's often called UA - Undifferentiated Arthritis.
Here's a clipping from a recent press release from the American College of Rheumatology - "Among those who seek out a doctor’s help for joint pain and stiffness, the most common diagnosis is undifferentiated arthritis (UA), or arthritic symptoms that do not add up to a specific arthritic disease. Spontaneous remission occurs in 40 to 50 percent of UA sufferers, while about one-third develop RA. Physicians often face the tough choice of whether to initiate DMARD therapy immediately or to wait and see. To guide individual treatment decisions, researchers with the Early Arthritis Clinic at Leiden University Medical Center , The Netherlands, have found a formula to help determine whether patients who present with UA are likely to progress to RA."
Link to the full article, "Predicting the Risk of Rheumatoid Arthritis for Early Arthritis Patients" http://www.rheumatology.org/press/2007/0207RArisk.asp
Hi Cathy,
Personally, I think September is an awfully long time to wait. I know, I know, patience is a virtue. But 6 or 7 months? Maybe I'm just lucky in that my rheumy sees me once every 4 or 5 weeks. I always have lots of questions and I also write them all down because my memory isn't what it should be anymore.
I had to quit my job too. I hate not working but don't know when I'll be able to go back. Hope you feel better soon.
My labs were and still are neg. after two years and my initial Dx was inflammatory arthritis also. Next my Dx was Palindromic RA and then full blown RA. All of these Dx's worked for my health insurance and to begin my SSDI filing. I do think that is quite a long time in between Dr visits, I go every 2 months.Just checking if it is not too much to ask, how old are those of you who quit your jobs. I am only 44 and single so no chance of doing that.
Cindy, I do think the important thing is that they are treating you. Here, it is typical 2-3 months between appointments with 3-4 months to get a new patient appointment. Your primary physcian is supposed to keep you going until then. But once you've been established as a patient, you should be able to get worked in sooner if needed. Since it does take awhile for those meds to have their full effect, that's probably the thinking of not having an appointment sooner. But here 6 months would be way too long. Suggest that if you are still not doing good to call and try to get worked in. Definitely bug your primary if that doesn't happen.
Quitting work is a tough decision, really painful.
Bonny, I was 48 when I started. I'm sure I will be over the magic age of 50 by the time I get it.
Cindy, your appointments sound like mine. You go in, have all theseThanks for all the replies. I do actually bring a list of questions however this time I was the last patient of the day and they were already way behind when I got there. We have a severe doctor shortage here in Canada. In my area there is only one rheumy for probably about 300,000 people. I go see a rheumy 2 hours away because the wait to see the one here is a year to a year and a half!
BrightLady, I was 48 when I had to quit my job (am now 49).
I took me 5 yrs to get a definate diagnosis. My rhuemy didnt want to "label" me with something that would stay the rest of my life if he wasnt absolutely positive. I have to respect him for that. THat may be the same thoughts your rhuemy is having. I know how you feel, I was beyond frustrated! He finally told me RA and sent me to Nashville for 2nd opinion,turns out he agreed. September seems like a long time to go between visits, I go every 2 to 3 months. Also, write down your questions so you dont forget and hand them to her if you have to. Good luck to you!