Viral arthritis

[pocohontas1]

Hi all. Haven't posted anything for ages as been trying to cope with going back to work. Done ok all things considered. However I'm still getting joint swelling and pain usually in my upper limbs, worse with activity like driving, writing, chopping etc. I've spoken to a medical friend of mine over the phone who wonders if I actually have a reactive arthritis following a nasty chest infection I had at Xmas. My joint problems came on at the end of the following March. My own doctor had ruled it out based on the time delay but my friend says she's seen people present with this even after months. Anyone else confirm the same?

[Beverley-NRAS]

Hi pocohontas1,

I have put a link below to some information about reactive arthritis for you to read:

arthritisresearchuk.org/sho...

I hope this helps you. if you are concerned then you can always ask for a second opinion:

nhs.uk/chq/Pages/910.aspx?C...

Regards

Beverley (NRAS Helpline)

[pocohontas1 in reply to Beverley-NRAS]

Thank you so much Beverley, I will read with interest and def consider another opinion.

[Hidden]

Hi Pocohontas. I just read your last post which I must have missed.

In answer to your question - I think the timing of your present flare in relation to the original infection makes it more likely that your PR has developed rather than burnt itself out as you had hoped it would.

I was initially diagnosed by my GP with post viral arthritis on the basis that I'd had Swine flu a few months earlier and had no visible swelling or hot boggy joints - just shed loads of pain in them and it was bilateral. He took my rheumatoid factor and inflammatory markers and told me that it would probably settle down. A few weeks later he phoned to say my RF was (weak) positive and my inflammatory markets were high so he felt we should assume I had RA and treat straight away. He had already referred me to rheumatology but I live in a remote place so clinics are not frequent.

Five years on I have tried and failed to tolerate four DMARDs and am now only taking a low dose of Prednisolone. The RA symptoms plagued me for two years and then everything went quiet in the joints apart from some early wear and tear. I've been off Methotrexate for over a year now and had anaphylaxis with Hydroxy and Sulfa and pancreatitis with Azathioprine. I am unusually allergic to many things though!

The important thing I wanted to explain is that my inflammatory arthritis or sero negative RA has never returned. I feel that Methotrexate and Hydroxy chased it off into the long grass. This doesn't correspond with the usual scenario for RA but presentations can differ enormously for each of us and there's no rule book in rheumatology!

I do have painful, longstanding parasthesia and my inflammatory markers still fluctuate dramatically according to pain and stiffness levels and my multiple symptoms change all the time. I am currently being investigated for Hughes Syndrome (APS) and Sjogrens with Raynauds and have some signs from my CSF that something systemic is occurring. Despite being told that my diagnosis was made on the strength of text book synovitis in my hands I am tempted to conclude that my RA was in fact either reactive arthritis or PR all along and that I probaby have undifferentiated connective ltissue disease and will always have annoying, sometimes very painful autoimmune symptoms. But I am learning as a very impatient person who deals very badly with this limbo land - that if I can make sense of what is happening to me then everything else is a question of learning to self manage with exercise, diet and the odd sleeping pill or slow release Tramadol.

I've no regrets about trying these powerful drugs at all however and if my new consultant felt I needed further immune suppression I would try it despite allergies to date.

My rule of thumb these days is to only take drugs that are intended to dampen down the disease process - if it's thought to be erosive. I will take nothing else that my body will depend on too much or find very hard to get off such as the anti depressant family or steroids. Slowly tapering off steroids now!

[pocohontas1 in reply to Hidden]

Thanks Twitchytoes. Very enlightening. I agree that less is more when it comes to meds, not that I'm against them (I'm a doctor!) just that I don't want to take something if it's not for the right indication/diagnosis. Especially considering potential side effects. Will let you know how things go......all the best to you.

[mcrparader]

I had tonsillitis (never had it before & only once since) in November 2007 my gp & Rheumy consultant both think it was the trigger for my ra & I was positive for rf.

It has never gone, but it has been very aggressive. I've been told I'm at the end of the road in terms of meds. I take over 70 tablets a day all prescribed by my Rheumy as well and rituximab infusions and weekly methotrexate injections.

The only things that keep me going are my kids 17 & 15 and work. I think if I didn't make myself get up for work in the mornings and have something to look forward to dwelling on the pain would be unbearable.

Mcrparader xxx

[pocohontas1]

Really hope things get better for you Mcrparader. You sound very brave.