I need advice on talking to Dr. about suspected R.A.

[hikinggal]

I have been having terrible pain in both elbows for over 4 months and pain and stiffness in both shoulders for over a year. I am finally going to the Dr. with these concerns but am not able to get in for a couple of weeks. I am afraid of my symptoms diminishing by the time I get to to see him and he will not take me seriously.

My question is will what ever exams that he performs on me indicate R.A. even if I am not in the height of a flare? I am thinking about performing some activities that make me extra sore (i.e. gardening, washing windows, etc.) right before the appointment

Thank you for your time.

Tammy

[helixhelix]

A diagnosis of an inflammatory arthritis is usually based on a mix of the results of blood tests, how you describe your symptoms and your actual physical symptoms on the day. So it's not just about the soreness, and if not actually swollen doctors can still feel if your joints are "boggy".

If you're in the U.K. what usually happens is that if you meet the criteria your GP will refer you to a specialist rheumatologist, it is the rheumatologist who makes the diagnosis. So all that might happen on a first appointment is some blood tests, and extra activity the day before is unlikely to make a difference. However, if you are taking over the counter anti-inflammatorys then stop a few days before. Also write down a history of your symptoms in advance as it will help you explain quickly. Your GP will also want to rule in or out other possibilities like tendonitis or osteo-arthritis.

[hikinggal in reply to helixhelix]

helixhelix, Thank you for your quick response. I do have osteoarthritis and a host of other issues in my spine (lumbar, cervical). Two years ago I went to see the Dr. due to severe lower back and hip pain and was told to try Yoga. Yes, Yoga is wonderful for all types of arthritis, however I was not amused. I ended up pushing for another MRI which revealed that my scoliosis was worsening. I opted for nerve ablation which helped.

I am sure most of you have had similar experiences with getting getting the correct diagnosis and proper treatment. I just do not want to be advised to try the "downward dog" for my elbows and shoulders.

Thank you,

Tammy

[ruth_p]

Keep a pain diary while you have the symptoms. Your GP will probably send you for blood tests to check your inflammation markers, which would still show even if you are not exhibiting external signs.

[hikinggal in reply to ruth_p]

Ruth, great idea! I will get started on that asap! That is what I was worried about, not showing inflammation because I am feeling better. Thank you for the quick response.

Tammy

[nomoreheels]

At this stage trying to make your symptoms worse isn't advisable & won't be helpful. You won't receive a diagnosis from your GP, he can only suspect & if he does after talking to you & doing a basic examination will have blood tests taken, usually rheumatoid factor & inflammation (ESR & CRP) & maybe anti-CCP. I would recommend that you stop taking any pain relief or anti-inflammatories you may have been taking a couple of days before you see him as they may suppress underlying inflammation & pain on palpating that he'll be looking for.

Maybe having a read of this will help you prepare, use the menu on the left of the first page to read further nras.org.uk/what-is-ra-article. This relates to the UK so if you're elsewhere your experience may differ.

[hikinggal in reply to nomoreheels]

Nomoreheels, Thank you for your advise. I am in the US, but the article was very helpful and I am sure applies to most countries. I did know that my GP could not diagnose this condition, but would refer me to a specialist. And therein lies the rub. He is stingy with his referrals.

Tammy

[jaydeeh]

Sounds rather like how mine started, at first sent to an orthopaedic and then physio. It was the NHS physio (I'd already been private and treated for tennis elbow) when I said pain had moved down my right now that she asked the GP for a blood test and then it was rushed through for a rheumatologist appt. Good luck!

[hikinggal in reply to jaydeeh]

Thank you jaydeeh for your reply. It sounds like you had a good physio. and I am glad you were taken care of so quickly!

Tammy

[DaniBeeLcLa]

Hi Hikinggal! I'm also in the US-I did a quiz in Arthritis Today magazine and showed to my PCP. Admittedly she is great doc and always takes my concerns seriously...she took a look at the results, started me on plaquinil and ordered blood tests and sent me to her mentor-the head of the rheumatology department. I highly recommend finding the quiz online and showing your doctor the results and if he/she doesn't listen, tell them you want a second opinion. Be persistent!

Good luck!

Dani

[hikinggal in reply to DaniBeeLcLa]

Dani,

Thank you for the idea. Yes, I will find, take it and take the results to my doctor. My appointment is this Wednesday so your email came at a perfect time!

It sounds like you have a great doctor. I hope you quickly find relief.

Tammy

[MOLLy8]

Hi Hikinggal, my RA was diagnosed after a yr. if your flare ups having been on and off it will show in your blood work. RA usually travels from area to area whether you excercise or not it will show in your blood work & xrays.

[DaniBeeLcLa]

Thanks Tammy! I'm doing pretty well because its summer. .I flare more when its chilly. Be sure to let us know how you're doing! Good luck on Wednesday!

Dani