Glad I took your advice

[mistymeana]

Hi All, well I plucked up courage and went to see my GP to ask for a referral to a named SpA specialist for a 2nd opinion. She was very kind but spent much time playing devil's advocate to prepare me for getting the same change of diagnosis. She had the x-ray results and confirmed there has been significant inflammatory osteo change but said there was also slight erosion on right index finger (didn't ask what that might mean and now wish I had). Said she will write to specialist to see what he says so looks like not certain he'll agree to see me and I'm trying not think what I'd do next if he refuses. So glad I went though as received letter from rheumy yesterday confirming she's discharging me and telling me to carry on with the Celecoxib but to try to reduce the dosage to the lowest effective if possible. Lots of mental shouting of "were you not listening to me - it isn't bloody working or I wouldn't have been referred back to you". Think I must have been talking Swahili in the consultation without realising it. Anyhoo, the sun is shining following a couple of days filthy weather so have decided to see that as a sign that things will get better.

[Hidden]

Hi Mistymeana. Glad you took the advice and went to see GP. I can only say that what I've gathered from research for myself (my hands seem to have OA and RA) is that with OA the bone grows around the joint whereas with RA the bone is eroded around the joint so they do look quite different on X-ray. I don't know enough about inflammatory OA to know if it is effectively treated with DMARDs or Biologics but I do really hope your consultant agrees to see you again and explains everything more to your satisfaction. If not could you perhaps try to find a private one with focus on SpA - especially if they could also see you on the NHS at some later stage? I know it's not ideal as have investigated this idea myself before but it might get you and your GP a bit further ahead with what's actually happening to you at least? Weather here is grey, windy, damp and kind of horrible if that's any consolation! Tilda x

[earthwitch]

Its a start, though obviously not as much support from your GP as would have been ideal. Here's hoping the specialist will agree to see you through the NHS. If not, then I guess as Tilda says, you could see if you could see them privately as a one-off. For me it was a private appointment with a SpA specialist that has really helped get things moving, but it doesn't always work if you stil have difficulty being seen in the NHS system.

The "erosions" could still be anything. There are so many different ways that damage can show up on fingers, but as Tilda has said, I am pretty sure "erosions" are more likely to be a sign of inflammatory damage. It really depends what else is going on to add to the whole picture, because inflammatory arthritis is never a diagnosis given on just one symptom or one area.

Know how you feel about continually getting discharged back to GP though - I've had to be re-referred four times now, and it has all got slightly boring to say the least. Would have been far more cost-effective for the NHS to have just kept me on their books and done a more thorough review and follow up, instead of just looking at one tiny bit at a time and starting from scratch each time with a new doctor.

[oldtimer]

Unfortunately, pressure from hospital managers means that it looks better for consultants to be seeing "new" patients than to continue to see "old" ones.

So they have to try to see more new referrals in their clinics. There is always the temptation for them to discharge someone back to the GP. Then when that person is referred again, it counts as a "new" referral.

Often, too, the time allocated in out-patients for a "new" case is longer than for someone who has been seen before. So make the most of your extra time if you have to be referred again!

[mistymeana in reply to oldtimer]

Thanks old-timer. Ironically, under those guidelines, I would have been classed as a new case as the hospital discharged me about 3 or 4 years ago and this went through as a new referral. The mind boggles what sore of consult I might have had as a returnee if this was extra time!