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Went to see Rheumatologist....

Posted by Kathy G on 5/24/03 at 08:52 (119804)

and I was right, I don't have Rheumatoid Arthritis! I was so relieved to hear an expert say it despite the fact that my PCP and I have been so sure that I don't have it.

The doctor I saw really impressed me. He was kind, approachable and acted as though he had all the time in the world, which was probably why he was running an hour behind schedule! He examined me very throughly; I was really impressed. He went on to say that the osteoarthritis is my CM joint (base of thumb) was quite severe although x-rays show that it isn't that advanced. He said that one had to take into consideration the symptoms and, like the last doctor I saw, he said the amount of swelling and pain is not consistent with the x-ray findings. He reassured me that I could get a shot of cortisone every four months and it would do no harm to the joint. He said his first reaction would be to be me on Vioxx but since I'm already on it, and I already wear a support to protect the joint, the shot is the next step.

I was pretty happy until he threw in the kicker. His examination of my spine indicated that I 'perhaps' have spondylitis, a form of arthritis of the lower spine. He was pretty vague about it but said there was medication that could be taken to control it. The only spondylitis that I'm familiar with is ankylosing spondylitis and I was so taken aback that I didn't even ask him if other types exist. With AS, as I'll call it, the lower vertebrae of the spine become inflamed and eventually fuse. It's a pretty lousy condition. The pain can be very severe and the meds they give for it are the DMARD's they give for RA and they can have some lousy side effects. I don't think I have it as the pain and stiffness in my lower back is no different than it was when I was sixteen years old. In fact, I didn't think my lower back was worth mentioning since it doesn't hurt any more than what I'm accustomed to. If anything, it's than it used to be when I exercised. I think I just have a weird body. I do have that pain near my waist that no one can relieve but I don't think it would be caused by this spondylitis. Anyhow, he ordered xrays and blood work and I'm to see him in a month. At that time, he said we'd review the results and he'll give me the shot of cortisone in my hand.

Interestingly, he said that he wondered if the pain in my feet was due to spondylitis. He said that if it wasn't, then it was the worst case of PF that he's ever seen. I wanted to tell him to check out the people on these boards. My case is nothing compared to many of the posters here but I decided to refrain from telling him that!

Bottom line is that if the tests are negative and I truly believe they will be, he says I have fibromyalgia which is already being treated with the four drugs he would prescribe: valium at bedtime, zoloft for pain control (you know, upping the seratonin level to help one deal with the pain), amitriptyline and carisopridol. He said my tenderness at the trigger points wasn't as severe as he's sees with most fibro patients but that he has never seen a patient who was already being appropriately treated. So score one for my PCP who I consider to be one of the best doctors I've ever met.

So that's where I am. If it's spondylitis, I'll deal with it because what else can I do? But I'm not going to read any more about it than I already have and I'm not going to obsess over it. My hand hurts a lot but again, I'm learning to deal with it. I just wish I didn't have bad feet and bad hands. (It's starting in my right hand but not as advanced as in my left hand.) He seemed pretty confident that he could control the pain with the cortisone injections and I'm hopeful that will be the case. Then I can just deal with my stupid feet and take appropriate measures to protect my hand but I can go back to gardening and crocheting and maybe even hold a book without so much pain.

So that's my long story, folks. It's nice to have someone besides my husband to share it with. One of my sisters doesn't care and the other one is dealing with problems with her bi-polar disorder and I don't want to dump anything on her. I need to be positive and upbeat and try to help her through this difficult period.

Thanks to you all for just being there!

Re: Went to see Rheumatologist....

Suzanne D on 5/24/03 at 09:19 (119806)

Kathy, I am glad you found this doctor who seems to be both thorough and compassionate, which can be a rare combination these days! I hope your test for spodylitis is negative. When will you hear? If it is fibromyalgia, then the fact that you are already doing a lot of the right things should help. I wish there was some 'magic bullet' that would make it all better for you! But you have a positive attitude and seem to be doing all the right things, so that will be on your side.

I'm glad we have each other to discuss these things with and to know that others understand and care! My sister doesn't really have time for me - hasn't in years - and often I feel no one outside this website really takes the time to understand many things. Just another reason I am so thankful for all of you!

You will be in my thoughts and prayers. [-o<

Suzanne :)

Re: Went to see Rheumatologist....

Carole C in NOLA on 5/24/03 at 10:04 (119810)

Kathy, I'm glad you found a rheumatologist that you like. It sounds like he's carefully checking various possibilities. And I'm glad he was able to diagnose your thumb pain. That has to be a big relief. Just not knowing can be so stressful sometimes.

I think you are smart not to stress out about the spondylitis. He's probably just covering all possibilities. After all, this is his specialty and he doesn't want to miss anything, especially if its progression can be slowed. Anyway, one way or the other you will know soon.

I too really appreciate being able to share these things with people here on the message board, when that's possible. Let's face it; nobody really wants to hear about foot problems unless they have experienced them too.

Carole C

Re: Went to see Rheumatologist....

Necee on 5/28/03 at 01:06 (120099)

I'm glad you found a Dr that you like and feel comfortable with. In this fast paced world where Drs rush us through like a bunch of cattle at an auction, it's nice to find someone who takes the time and really listens to our concerns and questions.
I wish you all the best.

Happy trails....

Necee