could I have RA or arthritis? | Arthritis Information

Hi, I am new to the board. About 6 weeks ago, I started waking up to pain and stiffness in my ankles and wrists/top of hands. It was painful to stand, as if my feet were pointed and would not flex. At first it lasted only for a few seconds, and by the time I took a few stpes the pain would subside. After several days, the pains and stiffness started to last a few minutes, but I could walk it off. After about 3 or 4 weeks, the pain/stiffness became more concentrated in my ankles and my wrists were feeling fine. The the pain/stiffness started to last for several hours, peaking always when I first awoke. It became difficult to walk. There were a few days where the symptoms would only last a few minutes, but other days where it took about 10-15 minutes before I could stand up even. About 2 weeks ago, the pain became predominant in the left ankle only (and my right wrist hurts often also). Some days the pain and stiffness are around he clock, peaking in the morning. I have tried bedrest and rest, but it does not seem to make a difference. One sunny day this week, I woke up and had no symptoms, but the next day they were back. My main issue now, for the past 2 weeks, is the very painful and stiff left ankle.

I am a stay home mom to young babies and have the same schedule every day. There is nothing I can think of that would contribute to these symtpoms. I walk around with the kids everyday and play. When I have tried laying down and resting for large parts of the day, it does not seem to have an impact. Motrin, tylenol srthritis, and alleve, and ice packs, often a little momentary relief.

We moved to CA recently and I am waiting for a rheumatologist who will take me here. the wait is estimated at 1-4 months. I have been diagnosed with several other autoimmune disease, including MS, but the stiffness really made me think of arthritis (and not neuropathis pain, as in MS). I am in my 30s and female.

thanks for any input

Dear LOMV, I'd get on the phone and start bugging the doctor for an 'opening' or get on a waiting list for an earlier appointment. Talk to who ever answers the phone and say, 'I'm in pain' or I Neeeed to see the Doctor!!" be firm about what is happening to you. Tell the person how it hurts, etc. Call everyday (you can catch them in the office???) You don't need this hanging over your life. You need to be able to enjoy your children without worrying. Good luck and let me know how you do! I started having swollen feet , the bottoms were like silly putty. Couldn't walk! or get my shoes on. Now my hands and about every joint is stiff at some time (different ones every day!!). My left knee and right elbow are stiff today, so you are right this could be arthritis. Good luck! Take charge! Demand attention and respect!Start with your primary care doctor while you are waiting to see a rheumatologist. Joint Pain is a symptom in many illnesses not all of them arthritis. Your Primary doc can start the ball rolling by doing some of the preliminary blood work

lomv,

I actually went to urgent care. I told them that I thought that my wrist was broken. They sent me for xrays and a week later, they (u/c) preliminarily diagnosed me with rheumatoid arthritis. Sounds like yours could be RA. Just stand in line and get ready for the wildest roller coaster ride you have ever been on.

LEV

Hi all, thanks for your comments! One of the problems is I can't even see a new primary until the end of March, and I have been waiting for the appt since early feb. I am in San Francisco, and a lot of drs I have contacted, including faculty clinics at UCSF (major academic hospital) are completely full and not even taking new patients. I am hesitant to go to a random dr here, since i have had bad experienced witht he run around (it took over 10 yrs of appts before I was diagnosed with MS, and I was diagnosed right away when I took myself to a good specialist int he city). I ahve called the rheumatology division at the hospitals near me, and they all have a long wait for new patients,a nd they say I can call wednesdays and fridays to check for cancellations (once a rheumatologist reviews my primary's letter of referral to detremine if I can be accepted as a new patient). To speed this up, my old dr in NY, where we moved from, is writing the letter, even though the symptoms are new and he has never seen me for it.

If anyone out there is in SF and can recommend someone, I'd really appreciate it.

Lev, the idea about urgent care is really good, since I wont need an appt (just a sitter for the babies). Is it generally clear-cut to diagnose RA or arthritis or other disease that cause these symtpoms? Are the blood tests quick and generally easy to read? Does it matter whether I am tested at the peak of symptoms? I wonder if it will be difficult to diagnose if I see someone on a day when my symptoms are not very pronounced.
Also, in the case that it is RA, do current treatments offer a lot of relief and prevent future damage?

Some days I have really intense symptoms, and it is so painful to stand up and flex my ankles into a standing position. Other days there is hardly any pain or just a few moments of pain int he morning. I have still been able to wear my shoes/slippers and don't feel very swollen, though it is tender, and I end up leaning my weight inward and dragging my foot since this makes it more bearable.

You might want to make a seperate post titled "Need a great RD in San Francisco" and see if you get some names that way. You should also put out feelers on the other RA boards.

www.4ratalk.com

www.rheumamisfits.com

www.arthritis.org they have a message board within this site

www.rasushi.jconserv.net

www.arthritisforums.iforumer.com

Trixie6639145.7058912037I feel so dumb when I try to log in on these things. Tried 4 times for 4ratalk! WHAT am I doing wrong? I keep registering, filling in the blanks and then say register me! Those numbers keep coming up??? A mystery

Welcome to the bay area. I live in the south bay...in Sunnyvale near San Jose. I'm afraid I don't know of any doctors in the city. Unfortunately, the blood tests can be ambiguous. My doctor diagnosed me based primarily on symptoms. If you do have RA, the medications can make a big difference, though they typically take a while to kick in. My first year with RA was pretty miserable, but I'm doing much better now...4 years later. It is important to get treatment early to avoid permanent joint damage.

Good Luck, Alan

Hi:

I was diagnosed with RA at urgent care. They did blood tests and xrays. The doc then referred me to a rheumy doc but it did take about 6weeks to see him. The urgent care doc gave me pain meds and anti inflammatories that help with the pain and swelling. They also set me up with a primary doc because I didn't have one. They are good at knowing who is taking new patients. They even set up the appt date.

Good luck, I hope you get some answers and relief soon!

CinDee

thanks again for all the support and advice. I called and asked about the urgent care. I can see a resident there and the typical wait is 3-4 hours (plus time for tests). Aside from seeing resident at UCSF for primary care (family care, general medicine, women's health, etc), there are only a few faulty who are taking new patients. I took the next available and will go in March (I also have appointments with 2 others who are better recommended but I have to wait until May and July to see them, and at that point I will pick the internist I like best).

For the blood tests and x-rays, does it make a difference to see someone when the symptoms are most active (especially if i am going into urgent care and seeing a resident).

thanks again. I do hope I can get this problem addressed soon. My babies are still little. We found a babysitter but she takes classes and only has free time on friday. Today I was able to walk around, but I hate waking up, only to realize I cannot stand without great pain and difficulty. I just can't figure out why some days are better than others. There were 2 sunny and wamr days this week, and I had much less symptoms, but there was also a sunny day where I had pain for hours. Does the weather or anything else commonly trigger a flare of symptoms?

Two days ago I woke up and couldn't bear any weight on my left foot/ankle at all. the only relief was to bend my inner foot up, walking a bit on the outer side of my foot. It did not offer enough support to walk, but I oculd hobble a short distance. I went to the urgent care, and they immediately brought me a wheelchair, much to my relief. waited 2 hours to see a nurse, got sent for x-rays (clear), bloodwork (sed rate normal, other bloodwork normal, but Rh factor not in yet). I have an appt with a rheumatologist on friday. e dr at urgent care sent me home wit a pair of crutches, and a rx for voltarin (NSAID) and vicoden. Neither took any edge of the pain, even when I tried 2 vic at night. I slept only 2.5 hours last night. If I moved my leg or foot the wrong way, there was tremendous pain. I went back today ( to review bloods and for them to get an update) and was given a rx for percocet. It has a litlte effect but not enough for me to walk wth my left foot flat or put pressure on my toes or inner part of my foot. My foot and ankle are starting to swell a moderate amount, which my hsband said is form not using it (becuase i am in pain).

The dr I saw, an orthopedist by training, thought it doesn't really seem like RA, given the normal sed rate, btu wants to wait until the RA factor and other tests come back. He thinks a rheumatologit is a good specialist to see first. I nothing pans out there, he says to see an orthopedist and maybe somehting is wrong with the tendons and they are spasmed/bunched up. The pain is really intense. For RA, is it a good idea to try to rest up or to try to work through the pain and mobilize more. I hvae young babies, so i have to be up quite a bit, though right now we have 2 other adults helping. The first day I was told to rest and put my leg up, but today he thought it might be good to try to move against the pain gradually (especially if the painkillers allowed me to do so).

Also, do any of you use walking aids for a painful foot/ankle/leg? The wheelchair was nice for me but I was tired moving around the streets in it (to get to the pharmacy, blood lab, picking up crutches, etc). I was gioven crutches, and i need them, but I find them cumbersome and tiring to use, especialy when I ahve to walk several blocks with them (and need to tie bags to hold my belongings to them). What about forearm crutches? or the device where you can put your knee on a rolling aid? The pain has been very high since yesterday morning and has not let up. I am unable to walk unassisted.
Any input appreciated.

You do NOT have to have positive blood work to have RA. Your blood work can be perfectly normal. So, yes you could have RA. Only a Rheumatologist can help decipher this. RA can also affect the tendons and caust tendonitis and other issues. I don't have any other advice that to say, please see a rheumatologist and please understand that your blood work can be perfectly normal with RA. An MRI might help shed some light on the ankel problem too.This is how mine started. It went on for a few years and I just dealt with it.
Then the flu like symptoms set in and that went on for a few more years
until I got a diagnoses a year ago. My pains seem to move around but
mainly affect my ankles and hands. I think going to urgent care is a really
good idea and will maybe get you started on some meds until you see a RD.
Good luck and keep us posted.Trixie is right-you could be seronegative. Read through the other posts on this board about that as there is a lot of info.

I have found that moving and exercise help me nore than bed rest. But if your pain is VERY intense that may not be a good idea. Maybe ask your doc for predisone to get you through this preliminary period. It is not a drug to be on long term but if you do have RA it can make it manageable until your are diagnosed and get your meds (DMARDS) in your system.

hessalina

You might try a walker to help you get around. Don't hesitate to use the electric scooters in the stores.

If you do a search on "Tara" and "San Francisco" doctors, you will see where she's recommended a couple fairly recently.

Some people use ankle splints to help.

This has to be hard with little ones.

Thanks everyone,
I had posted for SF drs and will be going to a rheumatologist tomorrow afternoon (that was recommended on these boards). I hvae bene in bed for nearly 2 days. I was given vicoden the first day in urgent care, but it didn't even put a dent in the pain. The next day, when I went in for a f/u and to review bloodwork (though rhematoid factor results still not in), I was given percocet. It has helped with the pain, and I can walk (with a limp-and cannot put my left foot flat on the ground) around a little. I am so exhausted though (maybe partly from taking percocet in the AM and in at bedtime) and ahve been sleeping nearly non-stop. I was in bed until 1pm and then napped again until 4:30pm and go to bed at 11pm. I ahve done this the past 2 days, so maybe it from the percocet, which cna make you drowsy. The sleep/rest has helped, I think. We have relatives oevr to help with the babies. I hope the bloodwork is complete so the rheumy can have a clearer pic of everything tomororw, and i hope get some answers. I guess it takes some people a long time to get dx'd.

I ahve taken prednisone (taper) for MS flares (after steroid IV), and it makes me pretty moody. I am shocked how much pain and fatigue I have though. I really need to find a solution soon.

Just also want to mention that I have negative labs and obvious RA so blood tests are only another tool not the total picture.

I went to a rheumy (Dr. Curtis) this afternoon. Last night i was able to walk unassisted, without the crutches. first I was limping and stiff in my left ankle and foot, but by morning I was fine. The rheumy dind't knwo what it was. He said my bloodwork came back perfect (RF <40) and all the elctrolytes were normal, etc. He says to call when I am having te symptoms and he will have a better sense. About 2 months ago, I was experienceing varying lengths of pain and stiffness (starting with several seconds and eventualy lasting hours), always staring upon wakening (or starting while I slept but was unaware of it?). Last Monday my ankle was cramped up and in great pain, and when the rheumy read the reports fromt he urgenst care dr about my ankle being cramped and stuck, he said it really didn't sound like an inflammatory process like RA or arthritis. He said he had no idea but didn't think an orthopedist would help either. He suggested we wait and to come see him again when the symptoms were active (hopefully it will happen on a weekday) and we will go from there. His first guess was taht it was from the meds I started recently, but then we decided it couldn't be that since I had symptoms for a lot longer than I ahve been on the meds. He is leaning towards a neurological cause but was mostly stumped. I guess it is difficult wihtout seeing me with the symptoms. the pain was so great, Id on't want it to return, but since it has been been ongoing for over 2 months, I would be surprised if they simply vanished now.

tahnsk for all the input. any suggestions?

Have you been to www.cpnhelp.org? Also, there's a Dr. doing that protocol in Sacramento - one of the best in the country.

Pip