I had my Rheumatology appointment on Tuesday. I went in well prepared with everything written down (a lot had happened since my last review) and my husband came with me.
Saw yet another locum consultant. She did listen to me and was good when I burst into tears about not being able to walk and the awful 3 month flare I've had coming off a big dose of steroids/being right down to 7.5mg Methotrexate for 7 weeks. But I have had a consultation of two different halves which has left me feeling confused 🤔
First she told me the stiffness in my feet and hands was from inflammation. She heard the little joints in the top of my foot crack when she manipulated them, inflammation she said.
She was very excited to examine my elbows and told me I had enthesitis, inflammation of the tendon at the insertion point and I had 'tennis elbow'. Inflammation she said.
What about my achillies tendons I asked? They're so stiff when I get up in the mornings I can't get my heels down on the floor (I'm wearing Dorsiwedge boots in bed to keep tendons stretched). Any walking or physio exercises make it worse. I've been like this for 10 months now, except for 3 weeks at Xmas when I was on steroids. As soon as the inflammation went down I could do physio without making things worse. There is some swelling around the back of the heel and I have pulling pains on the heel bone. Not inflammatory cause, mechanical she said.
If I've got enthesitis (inflammation) at both elbows and shoulders too, surely it's the cause of my achillies pain? She told me to rub ibroprofen gel on my elbows, ive been rubbing it on the achillies and back of heel and it's taking some of the swelling down and things feel a tiny bit better.
Then she looked my blood test results, ESR now down to its lowest ever 9 (highest I've ever been during a really bad flare is 29) and declared I had no inflammation! So now I feel really confused. I almost feel like she thought I was making it all up! A previous consultant said I was a 'flat liner' , had inflammation but it never showed well in blood tests.
On a plus point, I now have a June appointment (referral in January!) at podiatry for orthotics. I also pressed for feet X-rays which I've not had for years despite problems. Having a foot ultrasound too to look for inflammation.
I notice she's changed my diagnosis on blood test forms to IA instead of RA. I've been gong to the same Rheumatology dept for 11 years. getting fed up with being told something different by each Rheumatologist (this is my third locum in a row) and not making much headway.
Sorry for the rant 😯 Know many of you are in a much worse situation and thankfully my flare and joints are much better than a few months ago thanks to Methotrexate.