a R's Update

[Guest guest]

Two weeks ago I went to my new doctor(internist) for the first time

after my GP said I had RA. He said he was pretty sure at that time

that I had RA,(from test and examination) but I also tested pso for

Lupus. He did another blood test to verify it and to rule our

sjogrens. I went in yesterday and he said I tested pos for lupus again

(ANA test) but that is common with a pos RA factor, he doesnt feel I

have lupus now even though it could show up later. He also said that

I didnt have sjogrens(yipee). We continued to talk about my options

and the varios medications available. He said I could stay on the

aleve for now and then see how things go or go ahead with the mtx. I

told him that I wnated to be a bit more agressive than just the

aleve. so he put me on 7.5mg(3X2.5mg)a week(plus folic acid) to start

off. I go back in to him in a month for blood tests and if everything

looks good I will go back to my GP and have the blood tests every 4-6

weeks. He said that it will take about 3 months for the mtx to start

working.

I have some questions for others that are on mtx:

1) how long did it take for mtx to start working for you?

2)What did you see as the biggest change since beeing on MTX?

3) How much do you take?

4) How long have you been taking it?

I am really hurting today. My right hand is killing me, but I am not

sure if it is the RA or carpal Tunnel. My feet and knees are so

stiff. I just don't know how I will deal with this pain on a long

term basis. I am such a wimp!!

a R.

[Guest guest]

Hello, a R.!

Sorry that you are hurting. You don't sound like a wimp to me. I hope that

you are feeling much better very soon.

I can't answer your questions about MTX from personal experience, but I'm

hoping that some of our other members will. Since the MTX will most likely

take a few weeks or more before you notice any effects, did the doctor

recommend taking something with it in the meanwhile?

Just a gentle reminder that it's misleading for anyone, especially a

physician, to refer to the ANA test as the " lupus test " or to say that when

a patient has a positive ANA that the patient has tested positive for lupus.

This is not true. ANA can be positive for a great number of reasons (and can

even be positive in healthy individuals) - it is not specific to lupus

(sensitive, yes; specific, no). Some estimates are that only up to 10% of

all individuals who test positive for the ANA in the US will ever be diagnosed

with lupus.

Also, in the absence of an overlap syndrome, the true concurrence of SLE and

RA is rare. So, for the physician to diagnose you with RA now and say that

maybe lupus will be added later is a strange approach. It may be better to

say that your diagnosis is uncertain or that, for now, it is RA, but it

could be changed to SLE later. Or is that what your physician was saying?

In addition, as far as I know, there is no blood test yet that can rule out

(or rule in) Sjogren's Syndrome (much like RF or any other blood test

cannot either make or break an RA diagnosis alone). In fact, the

classification criteria for Sjogren's Syndrome are still being disputed

throughout the world. According to what I read in " The New Sjogren's

Syndrome Handbook " (1998, Oxford University Press), there are currently six

different groups who have distinct yet generally similar criteria sets that

have been proposed as a universal standard; there is no consensus yet.

If your physician ordered the anti-Ro/SS-A and/or the anti-La/SS-B antibody

tests, just be aware that those tests are not highly specific or sensitive

to Sjogren's Syndrome.

If anything, the minor salivary gland biopsy that can be done to aid in a

diagnosis of Sjogren's Syndrome would probably be the test most specific to

the disease.

Here is an excellent article in Medscape about Sjogren's Syndrome:

http://www.medscape.com/medscape/Rheumatology/TreatmentUpdate/2000/tu01/public/t\

oc-tu01.html

Here is a link to the Sjogren's Syndrome Foundation:

http://www.sjogrens.com/index.html

I hope what I've said here makes sense. You might have a few questions to

ask your doctor next time.

Good luck with the methotrexate!

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

From: " a R " <mquiltn@...>

< >

Sent: Wednesday, March 28, 2001 10:36 AM

Subject: [ ] a R's Update

> Two weeks ago I went to my new doctor(internist) for the first time

> after my GP said I had RA. He said he was pretty sure at that time

> that I had RA,(from test and examination) but I also tested pso for

> Lupus. He did another blood test to verify it and to rule our

> sjogrens. I went in yesterday and he said I tested pos for lupus again

> (ANA test) but that is common with a pos RA factor, he doesnt feel I

> have lupus now even though it could show up later. He also said that

> I didnt have sjogrens(yipee). We continued to talk about my options

> and the varios medications available. He said I could stay on the

> aleve for now and then see how things go or go ahead with the mtx. I

> told him that I wnated to be a bit more agressive than just the

> aleve. so he put me on 7.5mg(3X2.5mg)a week(plus folic acid) to start

> off. I go back in to him in a month for blood tests and if everything

> looks good I will go back to my GP and have the blood tests every 4-6

> weeks. He said that it will take about 3 months for the mtx to start

> working.

>

> I have some questions for others that are on mtx:

> 1) how long did it take for mtx to start working for you?

> 2)What did you see as the biggest change since beeing on MTX?

> 3) How much do you take?

> 4) How long have you been taking it?

>

> I am really hurting today. My right hand is killing me, but I am not

> sure if it is the RA or carpal Tunnel. My feet and knees are so

> stiff. I just don't know how I will deal with this pain on a long

> term basis. I am such a wimp!!

>

> a R.

[Guest guest]

,

I think what my doctor meant was that he couldnt verify that i had

lupus based on the ANA test since I dont show the other signs. I

asked him if it was posible to have lupus and RA at the same time and

he same definately yes. He didnt say how common it was though. as for

the sjorgrens, he just said i did have it, but i dont have any of the

symptoms either.

I have another question. Is carpal Tunnel related to RA? I had a bout

with CT prior to my diagnosis of RA but after the symptoms began. I

am having difficulty lately with alot of pain in my right hand( i

seem to have RA more in my left than my right hand) and wondered it

it could be RA or CT. the pain in in my wrist and i have difficulty

straigtening out my hand.

aR

> Hello, a R.!

>

> Sorry that you are hurting. You don't sound like a wimp to me. I

hope that

> you are feeling much better very soon.

>

> I can't answer your questions about MTX from personal experience,

but I'm

> hoping that some of our other members will. Since the MTX will most

likely

> take a few weeks or more before you notice any effects, did the

doctor

> recommend taking something with it in the meanwhile?

>

> Just a gentle reminder that it's misleading for anyone, especially a

> physician, to refer to the ANA test as the " lupus test " or to say

that when

> a patient has a positive ANA that the patient has tested positive

for lupus.

> This is not true. ANA can be positive for a great number of reasons

(and can

> even be positive in healthy individuals) - it is not specific to

lupus

> (sensitive, yes; specific, no). Some estimates are that only up to

10% of

> all individuals who test positive for the ANA in the US will ever

be diagnosed with lupus.

>

> Also, in the absence of an overlap syndrome, the true concurrence

of SLE and

> RA is rare. So, for the physician to diagnose you with RA now and

say that

> maybe lupus will be added later is a strange approach. It may be

better to

> say that your diagnosis is uncertain or that, for now, it is RA,

but it

> could be changed to SLE later. Or is that what your physician was

saying?

>

> In addition, as far as I know, there is no blood test yet that can

rule out

> (or rule in) Sjogren's Syndrome (much like RF or any other blood

test

> cannot either make or break an RA diagnosis alone). In fact, the

> classification criteria for Sjogren's Syndrome are still being

disputed

> throughout the world. According to what I read in " The New Sjogren's

> Syndrome Handbook " (1998, Oxford University Press), there are

currently six

> different groups who have distinct yet generally similar criteria

sets that

> have been proposed as a universal standard; there is no consensus

yet.

>

> If your physician ordered the anti-Ro/SS-A and/or the anti-La/SS-B

antibody

> tests, just be aware that those tests are not highly specific or

sensitive

> to Sjogren's Syndrome.

>

> If anything, the minor salivary gland biopsy that can be done to

aid in a

> diagnosis of Sjogren's Syndrome would probably be the test most

specific to

> the disease.

>

> Here is an excellent article in Medscape about Sjogren's Syndrome:

>

>

http://www.medscape.com/medscape/Rheumatology/TreatmentUpdate/2000/tu0

1/public/toc-tu01.html

>

> Here is a link to the Sjogren's Syndrome Foundation:

>

> http://www.sjogrens.com/index.html

>

>

> I hope what I've said here makes sense. You might have a few

questions to

> ask your doctor next time.

>

> Good luck with the methotrexate!

>

>

>

>

> ----- Original Message -----

> From: " a R " <mquiltn@p...>

> < @y...>

> Sent: Wednesday, March 28, 2001 10:36 AM

> Subject: [ ] a R's Update

>

>

> > Two weeks ago I went to my new doctor(internist) for the first

time

> > after my GP said I had RA. He said he was pretty sure at that time

> > that I had RA,(from test and examination) but I also tested pso

for

> > Lupus. He did another blood test to verify it and to rule our

> > sjogrens. I went in yesterday and he said I tested pos for lupus

again

> > (ANA test) but that is common with a pos RA factor, he doesnt

feel I

> > have lupus now even though it could show up later. He also said

that

> > I didnt have sjogrens(yipee). We continued to talk about my

options

> > and the varios medications available. He said I could stay on the

> > aleve for now and then see how things go or go ahead with the

mtx. I

> > told him that I wnated to be a bit more agressive than just the

> > aleve. so he put me on 7.5mg(3X2.5mg)a week(plus folic acid) to

start

> > off. I go back in to him in a month for blood tests and if

everything

> > looks good I will go back to my GP and have the blood tests every

4-6

> > weeks. He said that it will take about 3 months for the mtx to

start

> > working.

> >

> > I have some questions for others that are on mtx:

> > 1) how long did it take for mtx to start working for you?

> > 2)What did you see as the biggest change since beeing on MTX?

> > 3) How much do you take?

> > 4) How long have you been taking it?

> >

> > I am really hurting today. My right hand is killing me, but I am

not

> > sure if it is the RA or carpal Tunnel. My feet and knees are so

> > stiff. I just don't know how I will deal with this pain on a long

> > term basis. I am such a wimp!!

> >

> > a R.