Re: When you're not in remission? - Remission Criterion

[Guest guest]

But my point is - how can you have " remission " if you are on drugs.

In my mind, the drugs can make your RA symptoms go away, but that is

not the same as remissions.

And what the heck is " ESR (Westergren methold) " ?

> Jennie,

> Your doctor should read the American College of Rheumatology¹s

criteria for

> determining if you are in remission:

>

>

> ACR Classification Criteria for Determining Clinical Remission in

Rheumatoid

> Arthritis

> 5 or more of the following present at least two consecutive months:

>

> a. Morning stiffness < 15 minutes

> b. No fatigue

> c. No joint pain

> d. No joint tenderness or pain on motion

> e. No soft tissue swelling in joints or tendon sheaths

> f. ESR (Westergren methold) < 30 mm/hour for a female or 20

mm/hour for

> a male

>

> Exclusions: Clinical manifestations of active vasculitis,

pericarditis,

> pleuritis or myositis, and unexplained recent weight loss or fever

> attributable to rheumatoid arthritis will prohibit a designation

of complete

> clinical remission.

>

> Reference: Pinals RS, et.al.: Arthritis Rheum 24:1308, 1981.

>

> http://www.hopkins-

arthritis.som.jhmi.edu/edu/acr/acr.html#remis_rheum

>

[Guest guest]

The erythrocyte sedimentation rate (ESR), or sedimentation rate (sed rate),

is a measure of the settling of red blood cells in a tube of blood during

one hour. The rate is an indication of inflammation and increases in many

diseases. There are 3 methods that labs can use to measure sed rate,

Westergren's method, Wintrobe's method & Micro-sedimentation (Landau)

method. Westergren¹s is normally used in rheumatic disease testing, but

when results are given they specify which method was used because each

produces a slightly different result.

The remission you have while on drugs is drug-induced remission. This is

different from spontaneous remission. In some people, RA may be milder and

it might run a course of a year or two - particularly in younger people,

young kids - and will go into a spontaneous remission and not come back.

Most people are not that lucky, but in drug-induced remission, when you stop

the drug, then the disease creeps back.

Pregnancy is known to cause spontaneous remission. I went into remission

during one pregnancy yet flared terribly in another. Personally, I¹d take

any kind of remission because it sure is glorious!

a

> But my point is - how can you have " remission " if you are on drugs.

> In my mind, the drugs can make your RA symptoms go away, but that is

> not the same as remissions.

>

> And what the heck is " ESR (Westergren methold) " ?

>

>

>> > Jennie,

>> > Your doctor should read the American College of Rheumatology¹s

> criteria for

>> > determining if you are in remission:

>> >

>> >

>> > ACR Classification Criteria for Determining Clinical Remission in

> Rheumatoid

>> > Arthritis

>> > 5 or more of the following present at least two consecutive months:

>> >

>> > a. Morning stiffness < 15 minutes

>> > b. No fatigue

>> > c. No joint pain

>> > d. No joint tenderness or pain on motion

>> > e. No soft tissue swelling in joints or tendon sheaths

>> > f. ESR (Westergren methold) < 30 mm/hour for a female or 20

> mm/hour for

>> > a male

>> >

>> > Exclusions: Clinical manifestations of active vasculitis,

> pericarditis,

>> > pleuritis or myositis, and unexplained recent weight loss or fever

>> > attributable to rheumatoid arthritis will prohibit a designation

> of complete

>> > clinical remission.

>> >

>> > Reference: Pinals RS, et.al.: Arthritis Rheum 24:1308, 1981.

>> >

>> > http://www.hopkins-

> arthritis.som.jhmi.edu/edu/acr/acr.html#remis_rheum

>> >

>

>

>

>

[Guest guest]

I keep forgetting to ask my sedimentation rate, although I know my

rheumy looks at that each visit. I'm putting it on my list for next

visit to ask. No trusting my memory. So here is where I rate

remission wise:

a. Morning stiffness < 15 minutes - since he injected my joint near

my achilles and I started the exercises he gave me, no morning

stiffness unless I over do it.

b. No fatigue - HAHAHAHAHA, this has to be a joke

c. No joint pain - Not unless I over do it

d. No joint tenderness or pain on motion - Again, not unless I over

do it. Of course, when I over do it I only have pain for a short

time.

e. No soft tissue swelling in joints or tendon sheaths - None of this

f. ESR (Westergren methold) < 30 mm/hour for a female or 20 mm/hour

for a male - No idea, will ask though

So if you need to have 5 of the 6, I'm pretty much there on 4 of

them. Fatigue is not going away I don't think, and I'll check into

the last one.

Jennie

> >> > Jennie,

> >> > Your doctor should read the American College of Rheumatology¹s

> > criteria for

> >> > determining if you are in remission:

> >> >

> >> >

> >> > ACR Classification Criteria for Determining Clinical Remission

in

> > Rheumatoid

> >> > Arthritis

> >> > 5 or more of the following present at least two consecutive

months:

> >> >

> >> > a. Morning stiffness < 15 minutes

> >> > b. No fatigue

> >> > c. No joint pain

> >> > d. No joint tenderness or pain on motion

> >> > e. No soft tissue swelling in joints or tendon sheaths

> >> > f. ESR (Westergren methold) < 30 mm/hour for a female or 20

> > mm/hour for

> >> > a male

> >> >

> >> > Exclusions: Clinical manifestations of active vasculitis,

> > pericarditis,

> >> > pleuritis or myositis, and unexplained recent weight loss or

fever

> >> > attributable to rheumatoid arthritis will prohibit a

designation

> > of complete

> >> > clinical remission.

> >> >

> >> > Reference: Pinals RS, et.al.: Arthritis Rheum 24:1308, 1981.

> >> >

> >> > http://www.hopkins-

> > arthritis.som.jhmi.edu/edu/acr/acr.html#remis_rheum

> >> >

> >

> >

> >

> >

[Guest guest]

My energy level went noticeably down when I started methotrexate, so

I've always considered fatigue as much a side effect of the

medication as a symptom of the disease. I consider it the price I

have to pay to get rid of the pain and swelling. So it's kind of

hard for me to imagine having NO pain and NO fatigue at the same

time. (It is better, though, since I started the folic acid.)

> > >> > Jennie,

> > >> > Your doctor should read the American College of

Rheumatology¹s

> > > criteria for

> > >> > determining if you are in remission:

> > >> >

> > >> >

> > >> > ACR Classification Criteria for Determining Clinical

Remission

> in

> > > Rheumatoid

> > >> > Arthritis

> > >> > 5 or more of the following present at least two consecutive

> months:

> > >> >

> > >> > a. Morning stiffness < 15 minutes

> > >> > b. No fatigue

> > >> > c. No joint pain

> > >> > d. No joint tenderness or pain on motion

> > >> > e. No soft tissue swelling in joints or tendon sheaths

> > >> > f. ESR (Westergren methold) < 30 mm/hour for a female or

20

> > > mm/hour for

> > >> > a male

> > >> >

> > >> > Exclusions: Clinical manifestations of active vasculitis,

> > > pericarditis,

> > >> > pleuritis or myositis, and unexplained recent weight loss or

> fever

> > >> > attributable to rheumatoid arthritis will prohibit a

> designation

> > > of complete

> > >> > clinical remission.

> > >> >

> > >> > Reference: Pinals RS, et.al.: Arthritis Rheum 24:1308, 1981.

> > >> >

> > >> > http://www.hopkins-

> > > arthritis.som.jhmi.edu/edu/acr/acr.html#remis_rheum

> > >> >

> > >

> > >

> > >

> > >