So girding my loins, GP's in morning,

[Polo22]

So have an appointment with GP at 11 am tomorrow. Now this was supposed to be about pain/discomfort ? RA.

Of course they are bit sneaky and lots of other tests were included, but we aren't daft are we, we check first.

So Thyroid bloods , TSH 0.01 (0.27-4.20) FT4 21.6 (12-22) as usual no FT3 comment on result

"suggests overt-replacement".

Rheumatoid factor IGM level <10 (0.0-13.9) comment does say neg result does not exclude RA , where there is suspicion of disease anti-CCP antibody is more appropriate test , please send new sample for CCP. a negative RA factor result should not delay referral to Rheumatology. In fairness to her she did request anti CCP but it appears lab has decided not to do it.

Coeliac serology (TTG) was requested but no result

HbA1c still at 54 IFCCmmol/mol <41 ESR 15mm/h (2-19) (normal no action)

CRP 9 mg/L (0-4) (RCS) satisfactory/stable.

Vit D combined D2 + D3 125 nmol/L

also have Bone profile results, FBC, LFT, Renal profile, if anyone wants to know 🤔. So will be fighting to keep my Levo dose same, telling her I self medicate with T3, reinforcing again self injecting with B12 as believe have PA/absorption issues.

Hoping she will listen that heel pain/knee pain , back ache that has been around for years but crippling me for last 2 years is enthesitis , they have been listing it for years as "tendinitis" Their spelling not mine. Think it could be Psoriatic arthritis, just trying to get all my eggs in a line , and pick all your brains so I don't bugger it up and come out with less Levo and angry with myself for not standing my ground.

[Forestgarden]

What I've taken to doing is typing it all up beforehand, exactly what I want to say (symptoms, exactly what I want, research papers to back it up etc etc) and take it with me to the appointment. Hold on to it to remind yourself what you want to say, then hand it to them to put on file... it also gives the gp a get-out clause where they can say 'you knew the risks'!

[EchoWS]

Have you had an HLA B27 test?

[Polo22 in reply to EchoWS]

No , she (GP) had requested Anti - CCP and in brackets above the request was (HL7) , neither appear to have been done

[EchoWS in reply to Polo22]

I asked because I have nrAnkylosing Spondylitis and/or Psoriatic Arthritis and am HLA-B27+. So if you can get tested for it it would give you good information. I've had swollen achilles tendons and enthesitis on and off since 30. Finding the right biologic took time and NDT/T3 seems to help with the thickening of the tendon - but not with the enthesitis. There are other joints that have improved so much, feet improved, pelvic pain gone and low back pain so biking and walking so much better. I've see below you have referrals - good! Do research and stick to your guns!

[Batty1]

I have Psoriatic Arthritis (Enthesitis) absolutely brutal disease and yes it’s often mistaken as tendonitis but eventually if left untreated you could develop crystals on your tendons which is 100x’s worse then anything I have ever experienced in my life absolutely crippling.

Psoriatic Arthritis has no real test or blood test for diagnosis it really comes down to having psoriasis or family history of psoriasis and a competent doctor who understands PSA.

[Polo22]

Back from appointment. Well that was , erm, interesting and surprising. Batty1 they kept saying tendonitis I said No , had that , then it's plantar fasciitis, I said No had that too, this particular episode is coming up for 2 years. I woke at 3 am today to what felt like someone stabbing a hot needle through my ankle/heel I actually yelped, It's an excruciating pain isn't it. when it starts . Left Doc's after a free and frank discussion, with an Endo referral and a Rheumatology referral