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Re: when to see rheum dr

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Dawn, with things getting worse instead of better it is probably time to see another doctor and a rheumatologist (RD) is a good bet. A good RD will also be familiar with other auto-immune diseases because someone with one autoimmune disease is a good candidate for additional ones. Rheumatoid arthritis is only one of over 100 kinds of arthritis and there is much overlap among the symptoms of the different kinds. It often takes quite a while to get a definitive diagnosis but treating the symptoms should start much earlier. Most medicines for RA take a long time to become effective (several weeks to several months) but corticosteroids such as Prednisone act within days. The Prednisone is generally effective to ease the symptoms of inflammatory diseases of any kind but it does not stop the progession of joint damage and it has many troublesome side effects. If you use Prednisone I recommend getting off it as soon as possible (which for me took over a year so I could get out of bed and take care of myself). Also it it looks like you have an inflammatory arthritis such as RA I recommend going to a DMARD (disease-modifying antirheumatic drug) soon to stop joint damage. Plaquenil is reported to be the mildest DMARD followed by Methotrexate and Arava, Next come the biologics (Enbrel, Remicade, Kineret, and Humira) that are newer and much more expensive.

Stress definitely makes inflammatory arthritis worse for many people, but exercise is good for you. Just don't overdo.

Some people find diet has no effect while others find a strong correlation between diet and symptoms. You just have to find out what works for you by trial and error.

Good luck, God bless, and keep asking questions.

----- Original Message -----

From: duluth_aahs

Rheumatoid Arthritis

Sent: Saturday, May 10, 2003 6:38 AM

Subject: when to see rheum dr

Hi,I am 36 and have been having increasing problems over the last 6 years. First I was told I had Mono (went in for debilitating fatigue), then when the symptoms didn't go away Chronic Fatigue Syndrom was suggested. My thyroid, lyme disease and all the other blood tests are normal.Last year I was having tingling in my hands and feet that progressed to numbness. My Dr. suspected Reynaud's syndrom (another auto-immune disorder) and put me on a blood pressure med that corrected the numbness and tingling. But before the tingling I had extreme joint pain in my hands and left elbow (occasionally the right elbow but to a lesser extent). The joint pain comes and goes but didn't really change all that much.I was told last year that my rheumatoid factor was "slightly" elevated and this year she said it was even higher (although didn't give me any numbers). She said it still wasn't anything too out of the ordinary.I am having a bad week of hand pain but pretty much lots of fatigue (I am also prone to migraines so need to baby myself when tired or that will get me too!). I am still able to pick things up, go to work and feed my critter family but am worried about progression of problems.Is this enough to warrent going to a Rheum Dr., my regular Dr. didn't seem to think this was the time and pretty much said wait until I am more symptomatic as I have long periods with very mild symptoms (just appear to be lazy not ill :).I do have to say when I really make sure we are eating good foods (whole fruits, veggies, meats, made at home versus premade with chemicals added) I feel much better. I am also wondering if "over doing it" increases symptoms? It seems like if I start feeling better and get started with exercising that it comes back with a vengence. I usually stick to yoga and light weights, very short sessions. This weekend we went for a 45 minute hike in the woods with the dogs and although I thought I was going slowly to keep from stressing myself, this week has been awful and I am wondering if it was the walk or if it was going to happen anyway.Sorry about the long post and many questions!Dawn

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Hi Dawn,

I think it would be worth it to see a Rheumatologist for the symptoms

you are experiencing. Do you have an HMO or an insurance where you

need a referral from your primary care doctor? If so, explain to

your doctor about the pain you've been having with your hands & how

it hinders you. Plus the fact that your Rheumatoid Factor

was 'slightly elevated' (ask your doctor what it was...you have the

right to know), your insurance should approve you for at least one

visit with a Rheumatologist.

Good luck to you & let us know how things are going.

Barbara

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