Saturday, September 13, 2008

Rheumatology Update

Long appointment, long discussion, lots of information both directions. The rheumatologist is running updates of labs since some values may not appear until a few years and others need updates. I was prescribed a different NSAID that doesn't have to be taken often, so maybe that will reduce stomach problems. It doesn't seem to work very well though. I like ibuprofen, I just don't like the severe stomach pain.

He's looking at Remicade rather than Enbrel since it requires fewer injections (slows to once every 6 weeks rather than every 2 weeks). That might be better for the immune system.

In contrast to the Eastern medicine doctor, who says he would guarantee it's not an immune issue, the rheumatologist thinks I have an immune system problem and inflammatory problem that is creating the arthritis. The labs should give some information. He's still thinking spondylitis but wrote down more general categories for inflammatory arthritis that would include most anything. When googling for arthritis info, I ran across a paper he has written on differential diagnosis of many types of arthritis, giving exceptions, atypical presentations, and very unusual types of arthritis, so he definitely knows what he's doing. The jury's still out on exact causes for me. I can deal with shifting or general categories--I just want the pain under control. I'm no longer having the worst pain in the morning nor is my pain improving with movement. In any case, maybe we can get this under control.

I also started glucosamine since the clinical trials say it's as effective as NSAIDs after a few months' use.

Pool = good for me. Better than land, though I have to be careful not to overdo since I don't feel the pain then, but will later.

4 comments:

Donimo said...

I'm glad the rheumatologist spent a lot of time with you and that he has dealt with atypical arthritis. When will you have your lab results? I really hope it leads to better pain control. What does he think of you doing acupuncture? It's rare but it can happen that you get a specialist who is open to complementary medicine. I find it's so much better when they understand that you're working on your pain condition in a multitude of valid ways. Anyway, my hopes are with you.

FridaWrites said...

I thought I would have the lab results back already. They generally call. But maybe since I have a follow up in a few weeks they're holding them until then?

I didn't think to mention the acupuncture to him. Do you think it's a good idea? Maybe it is. It helped with the knee for sure. I did mention swimming.

Thanks for your good hopes!

blue-82 said...

I'm very interested in reading that paper, could you point me in the right direction? He sounds like a great doctor, I'm still in search of a diagnosis after 4 years.

FridaWrites said...

Send an email to frida, gmail and I'll send it to you.