I am a desperate son needing help for his mum. She has had little or no appetite for about 3 months. Has had edema in her lower legs for about two years but over the past 4 days swelling in her lower left arm and hand. She can’t grip anything. The little finger joint is bright red. I thought it was gout, but is now flaring up in the right hand as well. GP prescribed amoxicillin via a photo (wouldn’t attend). Can’t see how it could be a bacterial infection as it would not have jumped hands? Her blood test last week showed low haemoglobin 92g/l, and a low albumin level 36g/l. Please could you advise how Rheumatoid is diagnosed, and would it be preferable for the GP to start a short course of steroids to aid her appetite (as she must be malnourished), and reduce the inflammation. I’m not keen to continue with the antibiotics (Flucloxacillin) in case these upset her Liver. My mum is 89.
Thanks for any help you may be able to offer.
Much appreciated.
Neil
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NJCOL
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It sounds as if your mum is in a great deal of discomfort. I'm not a doctor, so I can only tell you that some of the symptoms your mother is presenting with were similar to mine. For example, I had swelling in my feet and both of my hands. Usually, RA presents on both sides of the body at the same time.
An initial course of steroids sounds like a good plan. In my case, I was initially given a steroid shot and naproxen (with a proton pump inhibitor) which helped address some of my pain. Following this, I was started on various RA medications.
The way that I was diagnosed is that my GP ordered blood tests. Following is some information of the type of blood tests a doctor might order:
I think it is the Anti-CCP test and rheumatoid factor test that are especially helpful in providing a diagnosis of RA. That said, while I ended up testing seropositive, some RA sufferers test seronegative.
I hope your mum receives more intensive medical care. Also, if you haven't already, I would bring up your suspicions of RA to your mum's GP. By the way, your mum is lucky to have you for a son.
I'm not a doctor so RA is systemic and is a different experience for each individual. So I'd suggest you ask her GP for a Full blood count and CRP test as this can help although a high CRP can just mean inflammation somewhere not just RA. And also ask the GP why at 89 he didn't visit ? I think it may be a case of saying she's housebound and requires a home visit. Any number of things could cause the symptoms you suggest and it'd be better to get proper qualified medical advice and I really would hesitate to go for steroids without a proper diagnosis so please do talk to her GP again. I do so hope she is feeling better soon.
I’d telephone & say very firmly you really think your mother needs to be seen.If you can’t persuade the receptionist to give you an appointment...ask to speak to the Practice Manager....believe me once you are old getting seen is really difficult...but if you stand your ground on behalf of your mother ...you will usually succeed.
Hello, thank you so much for your support, and the benefit of your experience. It’s contributors like yourself that make the cared for, and the carers, feel a little less isolated. Best wishes. Neil.
If you don’t get anywhere with the GP, or your Mum needs additional medical help over the weekend, call 111 and see if they can assist. Often they have “urgent care” appointments available. Sending best wishes to you and your Mum🌻
I ended up going to A&E twice before I was diagnosed and that’s what finally got the GP to listen a little bit. So it’s always worth trying to reach different doctors.
And if you get entirely desperate, you can pay to see a private rheumatologist with your Mum. This will typically cost between £180 - £240 but you can at least get a diagnosis further along. Good luck 🤞
I'm sorry about your mom. It sounds like she has had it extremely rough for awhile. You're a wonderful son trying to research ways to help her.
It could even be something vascular or even something nerve related. So I hope her GP can run tests and/or refer her to a specialist to determine if it's autoimmune, vascular, or something different. I have no RA diagnosis for my RA/autoimmune symptoms, so unfortunately I don't know what people here do.
Yet I had a few of the same issues your mom does, which I believe are attributed to my nerve problems. Years ago, even before I had the joint issues and inflammation, I was unable to grip with one of my hands. When I was diagnosed with neuropathy, the neurologist commented on my weakened hand muscle, along with my nerve symptoms. At that time, I also tested low for albumin, but doctor dismissed it, along with other things. But my hand never swelled up or became red., like your moms.
I also had a similar issue with my finger getting red and incredibly painful. A little over 6 months ago, around the time I started having more joint issues and redness on my knuckles & elbows, I started getting severe pain in my index finger, which would turn red (whole thing, not just knuckles), and I couldn't extend it. It felt like the blood flow was restricted, and it was excruciating. I started taking another nerve supplement that was known to help with blood flow. My index finger issue subsided within a few weeks.
So whether the issues are vascular, nerve related, autoimmune or other reason, I wish you both the best of luck in finding the cause soon, so she can get treatment and doesn't have so much pain.
Thank you for your reply and sorry to hear about the difficulties you have experienced. It is hard to work out what is going on, but at least contributors like yourself are so helpful in providing options to consider. I am most grateful and hope that you can find relief for your own issues. Best wishes. Neil
Hi Neil, it definitely sounds as if your mother has an inflammatory arthritis even is she doesn't have Rheumatoid arthritis. Another type is Psoriatic arthritis which can occur without a rash. These are usually diagnosed by blood tests and the RF factor doesn't always show up initially. I really feel for your mum. As Monique says below, RA usually presents on both sides, but not always. The GP ought really to refer your mum to a Rheumatologist for further help. Regarding her appetite I would suggest you ask her GP to advise on nutritional drinks. I'm guessing your mum is happy for you to talk with the GP on her behalf. I hope you get some joy soon...it's hard seeing someone you love feeling so unwell. It's good that she has a son who is so caring.
Neil, God bless you for being such a caring son. I can’t help too much but you’ve received good advice from others. The one thing I will say is that Ensure helped so much in helping to keep my mom well nourished when she stopped eating well. I believe it kept her going more than her meds did. I don’t know if you get it in the UK but it’s available in the supermarket here in the US. It’s a liquid meal supplement. I gave it to my mom cold and used a straw. She enjoyed them. They come in flavors. Best regards. Bonnie
Hi, I’m sorry your mum is having a tough time.. as others have said it’s a blood test to check RF factor (I think) Id ask for the practice manager at the surgery if you’re having no luck of even ring 111. It’s really not good enough. There’s a meal substitute called “complan” it can be bought in Boots, Superdrug etc but equally she should be able to have it on prescription. When my elderly Mum was struggling she used to like good old jelly & fruit. Good luck, I hope things get sorted out x
When my mum was not eating we bought her milkshakes drinks from the chemist who said whatever her issues they would not harm her and would keep up her strength. Speak to your doctor and be strong. If it was a pet the vet would act straight away. This is your mum and you both deserve better! Good luck and speak on here anytime 🌺
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