Re: More swelling + fatigue than joint damage

[Guest guest]

When I started I was on 40 mg Prednisone to permit me to struggle

to the bathroom and otherwise I was bedridden. This gave me lots of edema

and I was just sick in bed so I can’t really tell about fatigue. I

also was given a diuretic (Furosemide I think) along with Potassium to keep an

electrolyte balance. Once I got the RA under better control so I

could actually get up and do things I also was able to get off the Prednisone

and stop the diuretic. I also lost 20 pounds because of the untreated

illness, gained 40 pounds because of the Prednisone, and lost the excess weight

when I got off the Prednisone.

RA Criteria based on those from American College of

Rheumatology (Any 4 qualify for positive diagnosis)

1. Morning stiffness, lasting for at least an hour, present

daily for at least 6 weeks

2. Arthritis of 3 or more joints, lasting for at least 6 weeks

3. Arthritis of the hand joints, lasting for at least 6 weeks

4. Symmetric arthritis, lasting for at least 6 weeks

5. Rheumatoid nodules

6. Positive rheumatoid factor (blood test)

7. Joint changes on x-ray

You seem to be uncertain about your diagnosis so I thought I’d

post the above list of criteria. RA is so variable that no single one of

the criteria is mandatory for a positive diagnosis. You and your doctor

can decide if you have four or more of the criteria. Of course, there are

over 100 different kinds of inflammatory arthritis so even if it is not RA it

might be something similar that needs similar treatment. I hope you get

things well controlled. God bless.

From:

Rheumatoid Arthritis

[mailto:Rheumatoid Arthritis ] On Behalf Of kathy_d87

Sent: Monday, November 17, 2008 7:28 PM

Rheumatoid Arthritis

Subject: More swelling + fatigue than joint

damage

I wonder if anyone is like me? I have more

swelling/edema of the body

and fatigue than visible joint damage. My doctors are confused by this--

my fingers, feet, ankles, legs and abdomen swell throughout the day and

I have extreme fatigue.

But when the doctor does a physical exam he doesn't see damage, with

the exception of my knees--you can hear the lack of cartilage and

grinding.

Last week's checkup, the physician assistant said she heard fluid in my

lungs and I got another dose pack of prednisone. She and the rhummy

think it's time to change biologics from Humira to either Enbrel,

Rituxan, or Remicade.

My mother and her side of the family have a history of edema and nearly

all of them have diabetes (type 2) and heart problems. I am constantly

checked and so far no diabetes, but I do have mitral regurgitation. My

cardiologist sometimes gives me Lasix to reduce the fluid/swelling.

Sometimes it works, and other times the dose pack of prednisone works--

I guess it depends on the type of swelling that is occuring at the

time. I can't tell the difference but the cardiologist and rhummy can.

I wonder does RA cause overall body swelling or is it the mitral

regurgitation or both? I don't think the doctors really know. I'm in

a catch 22.

Anyone else having this problem--less external physical damage, but

more internal physical damage? BTW, my medical history is weird

anyway, Graves Disease at 14, severe allergies at 26 that resulted in

the diagnosis of RA at 26.

Any feedback is greatly appreciated.

Thanks,

K

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[Guest guest]

Thanks Harold--I qualify for all but #6 so far--I think I'm

seronegative regarding the Rheumatoid Factor. It's really hard to

drag myself to work each morning and by the time I get to work, the

swelling begins.

The dose pack works each time, but as you say you have a whole

another problem with prednisone side effects.

The Lasix doesn't remove the swelling as well, so I know the edema is

from inflammation. Hopefully, the doctors will get a handle on how

to handle it--the ball is in my court--to decide on changing from

Humira to either Enbrel, Remicade, Rituxan, or Orencia. Remicade is

really out of the picture because I can't take methotrexate.

Take care, God bless you,

Kathy

>

> When I started I was on 40 mg Prednisone to permit me to struggle

to the

> bathroom and otherwise I was bedridden. This gave me lots of edema

and I

> was just sick in bed so I can't really tell about fatigue. I also

was given

> a diuretic (Furosemide I think) along with Potassium to keep an

electrolyte

> balance. Once I got the RA under better control so I could

actually get up

> and do things I also was able to get off the Prednisone and stop the

> diuretic. I also lost 20 pounds because of the untreated illness,

gained 40

> pounds because of the Prednisone, and lost the excess weight when I

got off

> the Prednisone.

>

>

>

> RA Criteria based on those from American College of Rheumatology

(Any 4

> qualify for positive diagnosis)

>

> 1. Morning stiffness, lasting for at least an hour, present daily

for at

> least 6 weeks

> 2. Arthritis of 3 or more joints, lasting for at least 6 weeks

> 3. Arthritis of the hand joints, lasting for at least 6 weeks

> 4. Symmetric arthritis, lasting for at least 6 weeks

> 5. Rheumatoid nodules

> 6. Positive rheumatoid factor (blood test)

> 7. Joint changes on x-ray

>

>

>

> You seem to be uncertain about your diagnosis so I thought I'd post

the

> above list of criteria. RA is so variable that no single one of the

> criteria is mandatory for a positive diagnosis. You and your

doctor can

> decide if you have four or more of the criteria. Of course, there

are over

> 100 different kinds of inflammatory arthritis so even if it is not

RA it

> might be something similar that needs similar treatment. I hope

you get

> things well controlled. God bless.

>

>

>

> From: Rheumatoid Arthritis

> [mailto:Rheumatoid Arthritis ] On Behalf Of kathy_d87

> Sent: Monday, November 17, 2008 7:28 PM

> Rheumatoid Arthritis

> Subject: More swelling + fatigue than joint

damage

>

>

>

> I wonder if anyone is like me? I have more swelling/edema of the

body

> and fatigue than visible joint damage. My doctors are confused by

this--

> my fingers, feet, ankles, legs and abdomen swell throughout the day

and

> I have extreme fatigue.

>

> But when the doctor does a physical exam he doesn't see damage,

with

> the exception of my knees--you can hear the lack of cartilage and

> grinding.

>

> Last week's checkup, the physician assistant said she heard fluid

in my

> lungs and I got another dose pack of prednisone. She and the rhummy

> think it's time to change biologics from Humira to either Enbrel,

> Rituxan, or Remicade.

>

> My mother and her side of the family have a history of edema and

nearly

> all of them have diabetes (type 2) and heart problems. I am

constantly

> checked and so far no diabetes, but I do have mitral regurgitation.

My

> cardiologist sometimes gives me Lasix to reduce the fluid/swelling.

> Sometimes it works, and other times the dose pack of prednisone

works--

> I guess it depends on the type of swelling that is occuring at the

> time. I can't tell the difference but the cardiologist and rhummy

can.

>

> I wonder does RA cause overall body swelling or is it the mitral

> regurgitation or both? I don't think the doctors really know. I'm

in

> a catch 22.

>

> Anyone else having this problem--less external physical damage, but

> more internal physical damage? BTW, my medical history is weird

> anyway, Graves Disease at 14, severe allergies at 26 that resulted

in

> the diagnosis of RA at 26.

>

> Any feedback is greatly appreciated.

>

> Thanks,

>

> K

>

>

>

> No virus found in this incoming message.

> Checked by AVG - http://www.avg.com

> Version: 8.0.175 / Virus Database: 270.9.4/1794 - Release Date:

11/17/2008

> 8:48 AM

>