What to expect from the 1st visit to the Rheumatologist

[Guest guest]

Henci! (Creek Indian for hello)

I think I introduced myself a week or so ago, but just a recap:

Married, Native American, 5 kids, 33, strong family hx of RA,

started having pain in ankles and feet when getting out of bed about

2 months ago, have had pain in hands and wrists for a few years

that's getting progressively worse. No realy joint swelling that I

can visibly see, although my daughter tells me my hands look " old "

(of course, she's 16, anything and anybody over 21 looks old, lol).

I have an appt on Dec 12th for the first time to see the specialist.

I've already had a sed rate, ANA titer, RA factor and CBC done at my

GP's office, which is how I got referred to the specialist. My ANA

was high, my sed rate was high normal (right on the edge), my CBC

showed low Hemoglobin and high white cells, and my RA factor was 41,

with 20 being the top normal for that particular lab.

With all that under my belt, can anyone tell me what to expect? I've

read about Bone Scans, Xrays, MRI's..........I can't find a common

protocol when I've read information from the American Medical

Association, the Journal of American Medicine, or websites about RA.

That's really odd. Most diseases have a sort of established " path "

that you follow to confirm diagnosis, prognosis, and plan of

treatment. RA seems to be one where it's strictly up to the doctor.

I am a nurse and a college student so I have online access to quite a

bit of data and STILL I don't know what to expect when I go in there!

I realize that probably most of you will have had different

experiences depending on your condition when you went to the doctor,

but would anyone mind giving me a quick rundown on what I should be

prepared for when seeing the Rheumatologist for the first few times?

I really appreciate advice/information/ideas. Together we are

stronger than we are singularly.

Mvto (Creek Indian for thank you and goodbye combined!)

Cloud Seery

(cross posted into another RA community)

[Guest guest]

Welcome to the board. RA is indeed a

hard disease to diagnose because it can be so variable. In fact, there

are 7 criteria for diagnosis from the American College

of Rheumatology but any four qualify for a positive diagnosis because the

disease is so variable. In fact I think of it as a syndrome rather than a

disease because symproms and response to treatment vary so greatly. Here

is my quick summary of the diagnosis criteria

RA Criteria (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

I also have looked for good summary

information about RA that is neither too elementary nor too deep and the one I

like best is

General information about RA

http://www.arc.org.uk/about_arth/booklets/6033/6033.htm

Translating from English to American is

usually not too difficult. My doctor took x-rays of my hands and feet to

begin with 5 years ago and since my disease seems to be pretty well controlled

he hasn’t had any more taken. I started with Arava, switched to

Methotrexate, and then added Remicade at 3 mg/kg without much success.

Then we increased Remicade to 6 mg/kg and finally got enough relief to get off

Prednisone. It took about 18 months from beginning treatment to getting off

Prednisone. Now I’ve gone down to 4 mg/kg Remicade every 8 weeks

and 12.5 mg Methotrexate weekly.

If you have other questions someone here

can probably help you with answers. I noticed you are also helping others

and we appreciate that. God bless.

From: Rheumatoid Arthritis [mailto:Rheumatoid Arthritis ] On Behalf Of S Cloud

Sent: Sunday, November 19, 2006

11:04 AM

Rheumatoid Arthritis

Subject:

What to expect from the 1st visit to the Rheumatologist

Henci! (Creek Indian for hello)

I think I introduced myself a week or so ago, but just a recap:

Married, Native American, 5 kids, 33, strong family hx of RA,

started having pain in ankles and feet when getting out of bed about

2 months ago, have had pain in hands and wrists for a few years

that's getting progressively worse. No realy joint swelling that I

can visibly see, although my daughter tells me my hands look " old "

(of course, she's 16, anything and anybody over 21 looks old, lol).

I have an appt on Dec 12th for the first time to see the specialist.

I've already had a sed rate, ANA titer, RA factor and CBC done at my

GP's office, which is how I got referred to the specialist. My ANA

was high, my sed rate was high normal (right on the edge), my CBC

showed low Hemoglobin and high white cells, and my RA factor was 41,

with 20 being the top normal for that particular lab.

With all that under my belt, can anyone tell me what to expect? I've

read about Bone Scans, Xrays, MRI's..........I can't find a common

protocol when I've read information from the American Medical

Association, the Journal of American Medicine, or websites about RA.

That's really odd. Most diseases have a sort of established " path "

that you follow to confirm diagnosis, prognosis, and plan of

treatment. RA seems to be one where it's strictly up to the doctor.

I am a nurse and a college student so I have online access to quite a

bit of data and STILL I don't know what to expect when I go in there!

I realize that probably most of you will have had different

experiences depending on your condition when you went to the doctor,

but would anyone mind giving me a quick rundown on what I should be

prepared for when seeing the Rheumatologist for the first few times?

I really appreciate advice/information/ideas. Together we are

stronger than we are singularly.

Mvto (Creek Indian for thank you and goodbye combined!)

Cloud Seery

(cross posted into another RA community)

[Guest guest]

wrote: > With all that under my belt, can anyone tell me what to

expect? I've read about Bone Scans, Xrays, MRI's.....

Ardeith writes: Your RA doctor may want X-rays or MRI's to establish the

condition of your joints now......for comparison down the road if necessary.

Of course, the doctor will want to know of any allergies you may

have......and he or she may ask about your daily routines to determine where

you might be doing damage to your joints.

wrote: I can't find a common protocol when I've read information

from the American Medical Association, the Journal of American Medicine, or

websites about RA. That's really odd. Most diseases have a sort of

established " path "

that you follow to confirm diagnosis, prognosis, and plan of treatment.

Ardeith writes: That's because there is no " common protocol " .....RA affects

people in as many ways as there are people with the disease.....and those

people react to medications in many different ways. What works for me may

not do Harold a bit of good......but may only do SusieQ a small amount of

good.....we can't all tolerate the same medications or the same level of

exercise.....but the best advice I heard about exercise was to work on

flexibility.....keep gently flexing all the joints.....not to the point of

pain.....but gently flexing.....

Ardy