Successful hospital followup

Saw a brilliant doctor at the hospital today. She took the time to listen and answer my many questions (palindromic or ra and can I take nsaids along with mtx when my pain increases etc). She then did thorough examination before discussing options.

My blood results r showing raised esr and crp again with a resulting das of 4.7 so we agreed to start me on sulphasalazine on top of my 25mg of subcut mtx.

Lets hope this reduces my flare ups finally. Wow, what a difference it makes having an understanding doctor rather than critical one. :-)

14 Replies

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  • Glad you had a good appointment. Sounds like your doctor is really working well with you there.

  • That's such good news and I really hope it works well in reducing flare ups. I find your story very interesting and quite similar to mine in some ways. I too am never sure that the RA diagnosis stands and often wonder if it is in fact some inflammatory OA or a different kind of inflammatory arthritis altogether such as PsA. I think it's more than Palindromic simply because my hands have changed shape and fingers are slightly drifting - a little bit more each year perhaps and always stiff - but then I wonder about Gout or Vitamin D or endless other things that my research can reveal apart from RA. . Good doctors (understanding doctors = good in my book!) do make such a difference. My GP today was so friendly and sympathetic today but ultimately, as she says very often, she's a generalist and not a specialist and can only contribute towards the overall picture - not towards the diagnosis of RA. And when I see consultants they are usually on such a tight schedule that they can't answer the questions in a way that I really need them to. Fingers crossed that adding in Sulpha works well. I take Hydroxy as well as sub cut MTX but I've only just got up to 17.5 even thought I was diagnosed and started it a few months before you were. Good luck. Tilda xx

  • This doctor explained that my blood results and response to mtx reassures her that it is ra but the flares I had were palindromic in nature. What shocked me was when she said my wonky little finger and another one showed signs of oa. So the lumps and bending of them r not ra but oa!

    This is still confusing to me, but feel so much more confident about things now have spoken to this doctor.

  • Sounds almost identical to me! I too was having palandromic type flares that came on really suddenly and departed suddenly too and have knobbly fingers that are noticeably drifting. The rheumy said this was typical arthritis a few weeks ago and told me that's why I need to step up higher on MTX but not sure what sort of arthritis he meant because the MTX wouldn't make any difference to OA. The GP said to her it looks like RA and she thinks I'm too young for OA to be actually shifting things but I know lots of much younger people with OA. Of course she's a generalist so could only go by her long experience but if she looked at the Arthriits Care site forums she'd find loads of much younger people who are struggling with OA.

    Personally in my case I think it's both in my hands too but I think the RA has triggered the OA in them somehow. Maybe the same with you? Lots of people have both. Tilda x

  • My doctor said that oa comes on with age and did say ra can trigger it which surprised me. I know from the site that lots of people have both but I dont understand how they can decipher one arthritic nodule from another.

    So much I still dont understand.

  • Okay well it's like this Tina. If the top finger joints (PIPs) are swollen and knobbly and sore then that is usually a sign of OA.

    The middle ones can be either OA or RA or both - and the knuckles are usually very much connected with RA. With me my knuckles are always a bit raised now and tight so I can't fully clench my fingers and in the mornings they are particularly stiff. This is due to past RA flares I think.

    None of my fingers are swollen in the middle (MCP) joints anymore since taking MTX but they were quite badly swollen and sometimes red and hot and very painful to the touch in the months before and after I was diagnosed. This was what the rheumy diagnosed with RA on. They now have some bony lumps on the sides of MCP joints (Buchard's nodules - OA) and all ache if I squeeze them. My top finger joints all have hard pea like knobbles called Herberdean nodules on each of them which I hate and which only arrived after the RA. These are OA/ wear and tear I'm told by rheumy, physio and GPs. But I know they only arrived after the RA had started in my knees, feet, shoulders, wrists and fingers so I assume this is secondary OA - i.e it came because of the RA. Tilda x

  • Oh and I should add that my little finger on my right hand sticks right out off to the left and all my fingers on my right hand appear to be turning round so that the nail faces diagonally away from me. I don't know whether these changes are down to RA or OA. TTx

  • That makes sense - thanks.

    I have today got new inflammation in a new location - on top of my foot but ankle joint so painful to bring my foot upwards. Not had this before or heard of this one.

    This is a wierd disease. Hopefully a gd night sleep and tomorrow it may have cleared (along with the nausea that the sulphasalazine has brought with it).

    Hope u get some answers to ur queries from the rheumy team soon.

    Tina

  • So good to hear that you now have a doctor that knows what there doing x

  • It is lovely to hear from someone who has had a good experience from their hospital.. I am pleased that it went well for you.xxxx

  • Thanks sylvi,

    Credit where credit is due - dr reese was so positive, she discussed my treatment options including pros and cons for each before letting me decide - consultant up till now has always just told me what im to do.

    Wish they were all like her :-)

  • Glad that you are improving as I am. I just wish that I had seen my GP years ago instead of popping prescribed pain killers for pain in feet am pretty sure that was the start of RA John

    All the best

  • Im lucky in that respect - I was diagnosed within a month of my first symptoms starting so havnt suffered for years like many on here. Fingers crossed we continue to improve.

    Tina

  • Thanks everyone, its so nice to b able to share positive news with u all.

    Cyber hugs to all

    Tina

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