Re: Clarification on last post

[Guest guest]

,

The word terminal in stage four refers to terminal progression, which

means joint destruction.

In the fourth stage, fibrous tissue calcifies, resulting in bony

ankylosis and total immobility of the joint.

My ankles are probably considered stage IV since they are fused and

many bones are totally immobile.

In spite of the damage, I still walk on them.

Fibrosis -- Generation of fibrous tissue, such as in a scar.

Fibrous ankylosis -- Immobility and consolidation of a JOINT from

disease caused by fibrous tissue.

Fibrous tissue -- Tissue that is made up of fibers.

What exactly did your doctor say about your kidneys and liver? Did he

do a biopsy of your liver? Did he do a CAT scan or an MRI? Many of the

meds, particularly methotrexate, cause fibrous liver, which is also

called cirrhosis. In most cases, this damage is reversible after

discontinuing the medication. If your liver enzymes are elevated, it

could be caused by Imuran that you're taking. It can cause liver

toxicity, although it is rare - 1%

That is why they constantly monitor your blood so that they can

discontinue medication if liver toxicity is indicated by the blood

tests.

I'm really sorry for this bad news. I hope that you will call your

doctor and clarify the severity of your disease and what this all

means.

Since you've had RA for a long time, it is not surprising that your

joints may be in stage IV. I've had RA for close to 30 years and have

had to have my knees replaced due to total joint destruction. They are

now almost as good as new. Many times my blood tests have indicated

liver/kidney problems, but they were all related to the meds I was

taking, and my tests went back to normal when I stopped the med. I hope

this is the same for you.

a

On Aug 10, 2005, at 1:52 PM, Genest wrote:

> I am sorry for not clarifying this new stage. According to the

> American College of Rheumatology, RA is classified into four stages:

>

> Stage I-early: 1)No destructive changes on Xray Exam

>                2)Evidenidence of osteoporosis may be present

>

> Stage II-moderate: 1)Xray evidence of osteoporosis, with or without 

> slight bone destruction; slight cartilage may be present

>                    2) No joint deformities although

limitation of

> joint mobility may be present

>                    3) Adjacent muscle atrophy

>                    4) Nodules and tenosynovitis may be

present

>

> Stage III-severe: 1) Xray evidence of cartilage and bone

> destruction, in addition to osteoporosis

>                   2) Joint deformity such as subluxation,

ulnar

> deviation, or hyperextension, without fibrous or bony ankylosis

>                   3) Extensive muscle atrophy

>                   4) Nodules and tenosynovitis may be

present

>

> Stage IV-terminal: 1) Stage III criteria

>                    2) Fibrous or bony ankylosis

>

> I have severe subluxation and ulnar deviation on both hands and

> feet. I also have osteoporosis and cartilage & bone destruction;

> nodules everywhere, muscle atrophy, and fibrous ankylosis on both

> kidney and liver.

> I hope this clears a few things up. The website to go to is

> http://www.hopkins-arthritis.com/index.html

>

> Lots of prayers and hugs,

>

>

>

>

>

>

>

>

[Guest guest]

,

The word terminal in stage four refers to terminal progression, which

means joint destruction.

In the fourth stage, fibrous tissue calcifies, resulting in bony

ankylosis and total immobility of the joint.

My ankles are probably considered stage IV since they are fused and

many bones are totally immobile.

In spite of the damage, I still walk on them.

Fibrosis -- Generation of fibrous tissue, such as in a scar.

Fibrous ankylosis -- Immobility and consolidation of a JOINT from

disease caused by fibrous tissue.

Fibrous tissue -- Tissue that is made up of fibers.

What exactly did your doctor say about your kidneys and liver? Did he

do a biopsy of your liver? Did he do a CAT scan or an MRI? Many of the

meds, particularly methotrexate, cause fibrous liver, which is also

called cirrhosis. In most cases, this damage is reversible after

discontinuing the medication. If your liver enzymes are elevated, it

could be caused by Imuran that you're taking. It can cause liver

toxicity, although it is rare - 1%

That is why they constantly monitor your blood so that they can

discontinue medication if liver toxicity is indicated by the blood

tests.

I'm really sorry for this bad news. I hope that you will call your

doctor and clarify the severity of your disease and what this all

means.

Since you've had RA for a long time, it is not surprising that your

joints may be in stage IV. I've had RA for close to 30 years and have

had to have my knees replaced due to total joint destruction. They are

now almost as good as new. Many times my blood tests have indicated

liver/kidney problems, but they were all related to the meds I was

taking, and my tests went back to normal when I stopped the med. I hope

this is the same for you.

a

On Aug 10, 2005, at 1:52 PM, Genest wrote:

> I am sorry for not clarifying this new stage. According to the

> American College of Rheumatology, RA is classified into four stages:

>

> Stage I-early: 1)No destructive changes on Xray Exam

>                2)Evidenidence of osteoporosis may be present

>

> Stage II-moderate: 1)Xray evidence of osteoporosis, with or without 

> slight bone destruction; slight cartilage may be present

>                    2) No joint deformities although

limitation of

> joint mobility may be present

>                    3) Adjacent muscle atrophy

>                    4) Nodules and tenosynovitis may be

present

>

> Stage III-severe: 1) Xray evidence of cartilage and bone

> destruction, in addition to osteoporosis

>                   2) Joint deformity such as subluxation,

ulnar

> deviation, or hyperextension, without fibrous or bony ankylosis

>                   3) Extensive muscle atrophy

>                   4) Nodules and tenosynovitis may be

present

>

> Stage IV-terminal: 1) Stage III criteria

>                    2) Fibrous or bony ankylosis

>

> I have severe subluxation and ulnar deviation on both hands and

> feet. I also have osteoporosis and cartilage & bone destruction;

> nodules everywhere, muscle atrophy, and fibrous ankylosis on both

> kidney and liver.

> I hope this clears a few things up. The website to go to is

> http://www.hopkins-arthritis.com/index.html

>

> Lots of prayers and hugs,

>

>

>

>

>

>

>

>

[Guest guest]

According to my doctor, my lab tests, and numerous ct scans and mri.

I have terminal progression of my joint in both hands, both feet,

and lower spine. I have fibrous tissue in both kidneys and liver. My

right kidney is in failure due to the firbrous tissue blocking the

ureter. I go to dialysis once a week. I have had two liver biopsies

to rule out cancer. It showed that I am in premature liver failure.

My blood is monitered once a month. The Imuran is a catch 22. It can

help slow the progression of RA but it is toxic to the liver. All my

fingers, except for my thumbs, have replacement joints in them. Both

my wrists have been fused. They show severe degeneration. So does my

lower spine and hips. There is nothing that can stop the damage that

has been done, but he said we can prevent it from getting worse.

That is my goal. I can live with one kidney and we can work on meds

that will do their job instead of destroying healthy tissue.

Does this answer any of your questions?

G

>

> > I am sorry for not clarifying this new stage. According to the

> > American College of Rheumatology, RA is classified into four

stages:

> >

> > Stage I-early: 1)No destructive changes on Xray Exam

> >                2)Evidenidence of osteoporosis may

be present

> >

> > Stage II-moderate: 1)Xray evidence of osteoporosis, with or

without 

> > slight bone destruction; slight cartilage may be present

> >                    2) No joint deformities

although limitation of

> > joint mobility may be present

> >                    3) Adjacent muscle atrophy

> >                    4) Nodules and

tenosynovitis may be present

> >

> > Stage III-severe: 1) Xray evidence of cartilage and bone

> > destruction, in addition to osteoporosis

> >                   2) Joint deformity such as

subluxation, ulnar

> > deviation, or hyperextension, without fibrous or bony ankylosis

> >                   3) Extensive muscle atrophy

> >                   4) Nodules and tenosynovitis

may be present

> >

> > Stage IV-terminal: 1) Stage III criteria

> >                    2) Fibrous or bony

ankylosis

> >

> > I have severe subluxation and ulnar deviation on both hands and

> > feet. I also have osteoporosis and cartilage & bone destruction;

> > nodules everywhere, muscle atrophy, and fibrous ankylosis on

both

> > kidney and liver.

> > I hope this clears a few things up. The website to go to is

> > http://www.hopkins-arthritis.com/index.html

> >

> > Lots of prayers and hugs,

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

According to my doctor, my lab tests, and numerous ct scans and mri.

I have terminal progression of my joint in both hands, both feet,

and lower spine. I have fibrous tissue in both kidneys and liver. My

right kidney is in failure due to the firbrous tissue blocking the

ureter. I go to dialysis once a week. I have had two liver biopsies

to rule out cancer. It showed that I am in premature liver failure.

My blood is monitered once a month. The Imuran is a catch 22. It can

help slow the progression of RA but it is toxic to the liver. All my

fingers, except for my thumbs, have replacement joints in them. Both

my wrists have been fused. They show severe degeneration. So does my

lower spine and hips. There is nothing that can stop the damage that

has been done, but he said we can prevent it from getting worse.

That is my goal. I can live with one kidney and we can work on meds

that will do their job instead of destroying healthy tissue.

Does this answer any of your questions?

G

>

> > I am sorry for not clarifying this new stage. According to the

> > American College of Rheumatology, RA is classified into four

stages:

> >

> > Stage I-early: 1)No destructive changes on Xray Exam

> >                2)Evidenidence of osteoporosis may

be present

> >

> > Stage II-moderate: 1)Xray evidence of osteoporosis, with or

without 

> > slight bone destruction; slight cartilage may be present

> >                    2) No joint deformities

although limitation of

> > joint mobility may be present

> >                    3) Adjacent muscle atrophy

> >                    4) Nodules and

tenosynovitis may be present

> >

> > Stage III-severe: 1) Xray evidence of cartilage and bone

> > destruction, in addition to osteoporosis

> >                   2) Joint deformity such as

subluxation, ulnar

> > deviation, or hyperextension, without fibrous or bony ankylosis

> >                   3) Extensive muscle atrophy

> >                   4) Nodules and tenosynovitis

may be present

> >

> > Stage IV-terminal: 1) Stage III criteria

> >                    2) Fibrous or bony

ankylosis

> >

> > I have severe subluxation and ulnar deviation on both hands and

> > feet. I also have osteoporosis and cartilage & bone destruction;

> > nodules everywhere, muscle atrophy, and fibrous ankylosis on

both

> > kidney and liver.

> > I hope this clears a few things up. The website to go to is

> > http://www.hopkins-arthritis.com/index.html

> >

> > Lots of prayers and hugs,

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

,

Yikes, I guess it does answer my questions. This is not the answer I

expected to hear.

I'm really sorry. I know the Imuran is supposed to stop the

progression, but isn't organ

toxicity a reason to try to find something else that isn't so toxic to

your organs?

You've had this disease for a long time and have probably tried

everything to stop this nasty disease.

Every time my doctors tried to give me methotrexate, it affected my

liver and had to be discontinued.

How long have you been on Enbrel? Enbrel has helped me more than any

drug I've

ever taken, but I haven't tried Humira, Remicade or Kineret so I don't

know if there is

something more effective for me. Enbrel helps so much that I'm afraid

to mess with a good thing.

How long have you been on the Imuran? Were the finger replacements a

success?

I really hope your doctor can find something to help your joints but

not hurt your organs so much.

It is such a balancing act. Have you ever gone to the Mayo Clinic or

Hopkins?

Of course you don't have to answer any of my many questions. Does your

doctor have any

treatment in mind? I can send you research articles if you want. You

seem to be able to find

good information yourself, but I don't know if it's painful for you to

type, so just know the offer

is there for any help I can give.

a

On Aug 11, 2005, at 12:01 AM, Genest wrote:

> According to my doctor, my lab tests, and numerous ct scans and mri.

> I have terminal progression of my joint in both hands, both feet,

> and lower spine. I have fibrous tissue in both kidneys and liver. My

> right kidney is in failure due to the firbrous tissue blocking the

> ureter. I go to dialysis once a week. I have had two liver biopsies

> to rule out cancer. It showed that I am in premature liver failure.

> My blood is monitered once a month. The Imuran is a catch 22. It can

> help slow the progression of RA but it is toxic to the liver. All my

> fingers, except for my thumbs, have replacement joints in them. Both

> my wrists have been fused. They show severe degeneration. So does my

> lower spine and hips. There is nothing that can stop the damage that

> has been done, but he said we can prevent it from getting worse.

> That is my goal. I can live with one kidney and we can work on meds

> that will do their job instead of destroying healthy tissue.

> Does this answer any of your questions?

>

> G

>

>

>

>

>

> >

> > > I am sorry for not clarifying this new stage. According to the

> > >  American College of Rheumatology, RA is classified into four

> stages:

> > >

> > >  Stage I-early: 1)No destructive changes on Xray Exam

> > >                 2)Evidenidence

of osteoporosis may

> be present

> > >

> > >  Stage II-moderate: 1)Xray evidence of osteoporosis, with or

> without 

> > >  slight bone destruction; slight cartilage may be present

> > > 

                   2) No

joint deformities

> although limitation of

> > >  joint mobility may be present

> > > 

                   3)

Adjacent muscle atrophy

> > > 

                   4)

Nodules and

> tenosynovitis may be present

> > >

> > >  Stage III-severe: 1) Xray evidence of cartilage and bone

> > >  destruction, in addition to osteoporosis

> > >                    2)

Joint deformity such as

> subluxation, ulnar

> > >  deviation, or hyperextension, without fibrous or bony ankylosis

> > >                    3)

Extensive muscle atrophy

> > >                    4)

Nodules and tenosynovitis

> may be present

> > >

> > >  Stage IV-terminal: 1) Stage III criteria

> > > 

                   2)

Fibrous or bony

> ankylosis

> > >

> > >  I have severe subluxation and ulnar deviation on both hands and

> > >  feet. I also have osteoporosis and cartilage & bone destruction;

> > >  nodules everywhere, muscle atrophy, and fibrous ankylosis on

> both

> > >  kidney and liver.

> > >  I hope this clears a few things up. The website to go to is

> > > http://www.hopkins-arthritis.com/index.html

> > >

> > >  Lots of prayers and hugs,

> > > 

> > >

> > >

> > >

> > >

> > >

> > >

> > >

[Guest guest]

,

Yikes, I guess it does answer my questions. This is not the answer I

expected to hear.

I'm really sorry. I know the Imuran is supposed to stop the

progression, but isn't organ

toxicity a reason to try to find something else that isn't so toxic to

your organs?

You've had this disease for a long time and have probably tried

everything to stop this nasty disease.

Every time my doctors tried to give me methotrexate, it affected my

liver and had to be discontinued.

How long have you been on Enbrel? Enbrel has helped me more than any

drug I've

ever taken, but I haven't tried Humira, Remicade or Kineret so I don't

know if there is

something more effective for me. Enbrel helps so much that I'm afraid

to mess with a good thing.

How long have you been on the Imuran? Were the finger replacements a

success?

I really hope your doctor can find something to help your joints but

not hurt your organs so much.

It is such a balancing act. Have you ever gone to the Mayo Clinic or

Hopkins?

Of course you don't have to answer any of my many questions. Does your

doctor have any

treatment in mind? I can send you research articles if you want. You

seem to be able to find

good information yourself, but I don't know if it's painful for you to

type, so just know the offer

is there for any help I can give.

a

On Aug 11, 2005, at 12:01 AM, Genest wrote:

> According to my doctor, my lab tests, and numerous ct scans and mri.

> I have terminal progression of my joint in both hands, both feet,

> and lower spine. I have fibrous tissue in both kidneys and liver. My

> right kidney is in failure due to the firbrous tissue blocking the

> ureter. I go to dialysis once a week. I have had two liver biopsies

> to rule out cancer. It showed that I am in premature liver failure.

> My blood is monitered once a month. The Imuran is a catch 22. It can

> help slow the progression of RA but it is toxic to the liver. All my

> fingers, except for my thumbs, have replacement joints in them. Both

> my wrists have been fused. They show severe degeneration. So does my

> lower spine and hips. There is nothing that can stop the damage that

> has been done, but he said we can prevent it from getting worse.

> That is my goal. I can live with one kidney and we can work on meds

> that will do their job instead of destroying healthy tissue.

> Does this answer any of your questions?

>

> G

>

>

>

>

>

> >

> > > I am sorry for not clarifying this new stage. According to the

> > >  American College of Rheumatology, RA is classified into four

> stages:

> > >

> > >  Stage I-early: 1)No destructive changes on Xray Exam

> > >                 2)Evidenidence

of osteoporosis may

> be present

> > >

> > >  Stage II-moderate: 1)Xray evidence of osteoporosis, with or

> without 

> > >  slight bone destruction; slight cartilage may be present

> > > 

                   2) No

joint deformities

> although limitation of

> > >  joint mobility may be present

> > > 

                   3)

Adjacent muscle atrophy

> > > 

                   4)

Nodules and

> tenosynovitis may be present

> > >

> > >  Stage III-severe: 1) Xray evidence of cartilage and bone

> > >  destruction, in addition to osteoporosis

> > >                    2)

Joint deformity such as

> subluxation, ulnar

> > >  deviation, or hyperextension, without fibrous or bony ankylosis

> > >                    3)

Extensive muscle atrophy

> > >                    4)

Nodules and tenosynovitis

> may be present

> > >

> > >  Stage IV-terminal: 1) Stage III criteria

> > > 

                   2)

Fibrous or bony

> ankylosis

> > >

> > >  I have severe subluxation and ulnar deviation on both hands and

> > >  feet. I also have osteoporosis and cartilage & bone destruction;

> > >  nodules everywhere, muscle atrophy, and fibrous ankylosis on

> both

> > >  kidney and liver.

> > >  I hope this clears a few things up. The website to go to is

> > > http://www.hopkins-arthritis.com/index.html

> > >

> > >  Lots of prayers and hugs,

> > > 

> > >

> > >

> > >

> > >

> > >

> > >

> > >

[Guest guest]

,

I am so very sorry that your going through so much right now. I hope

that your doctor can put you on something, and things will get

better. Will keep you in my prayers, Tawny

> > >

> > > > I am sorry for not clarifying this new stage. According to

the

> > > >  American College of Rheumatology, RA is classified into

four

> > stages:

> > > >

> > > >  Stage I-early: 1)No destructive changes on Xray Exam

> > > >                 2)

Evidenidence of osteoporosis may

> > be present

> > > >

> > > >  Stage II-moderate: 1)Xray evidence of osteoporosis, with or

> > without 

> > > >  slight bone destruction; slight cartilage may be present

> > > > 

                 Â

  2) No joint deformities

> > although limitation of

> > > >  joint mobility may be present

> > > > 

                 Â

  3) Adjacent muscle atrophy

> > > > 

                 Â

  4) Nodules and

> > tenosynovitis may be present

> > > >

> > > >  Stage III-severe: 1) Xray evidence of cartilage and bone

> > > >  destruction, in addition to osteoporosis

> > > > 

                 

2) Joint deformity such as

> > subluxation, ulnar

> > > >  deviation, or hyperextension, without fibrous or bony

ankylosis

> > > > 

                 

3) Extensive muscle atrophy

> > > > 

                 

4) Nodules and tenosynovitis

> > may be present

> > > >

> > > >  Stage IV-terminal: 1) Stage III criteria

> > > > 

                 Â

  2) Fibrous or bony

> > ankylosis

> > > >

> > > >  I have severe subluxation and ulnar deviation on both

hands and

> > > >  feet. I also have osteoporosis and cartilage & bone

destruction;

> > > >  nodules everywhere, muscle atrophy, and fibrous ankylosis

on

> > both

> > > >  kidney and liver.

> > > >  I hope this clears a few things up. The website to go to is

> > > > http://www.hopkins-arthritis.com/index.html

> > > >

> > > >  Lots of prayers and hugs,

> > > > 

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

[Guest guest]

,

I am so very sorry that your going through so much right now. I hope

that your doctor can put you on something, and things will get

better. Will keep you in my prayers, Tawny

> > >

> > > > I am sorry for not clarifying this new stage. According to

the

> > > >  American College of Rheumatology, RA is classified into

four

> > stages:

> > > >

> > > >  Stage I-early: 1)No destructive changes on Xray Exam

> > > >                 2)

Evidenidence of osteoporosis may

> > be present

> > > >

> > > >  Stage II-moderate: 1)Xray evidence of osteoporosis, with or

> > without 

> > > >  slight bone destruction; slight cartilage may be present

> > > > 

                 Â

  2) No joint deformities

> > although limitation of

> > > >  joint mobility may be present

> > > > 

                 Â

  3) Adjacent muscle atrophy

> > > > 

                 Â

  4) Nodules and

> > tenosynovitis may be present

> > > >

> > > >  Stage III-severe: 1) Xray evidence of cartilage and bone

> > > >  destruction, in addition to osteoporosis

> > > > 

                 

2) Joint deformity such as

> > subluxation, ulnar

> > > >  deviation, or hyperextension, without fibrous or bony

ankylosis

> > > > 

                 

3) Extensive muscle atrophy

> > > > 

                 

4) Nodules and tenosynovitis

> > may be present

> > > >

> > > >  Stage IV-terminal: 1) Stage III criteria

> > > > 

                 Â

  2) Fibrous or bony

> > ankylosis

> > > >

> > > >  I have severe subluxation and ulnar deviation on both

hands and

> > > >  feet. I also have osteoporosis and cartilage & bone

destruction;

> > > >  nodules everywhere, muscle atrophy, and fibrous ankylosis

on

> > both

> > > >  kidney and liver.

> > > >  I hope this clears a few things up. The website to go to is

> > > > http://www.hopkins-arthritis.com/index.html

> > > >

> > > >  Lots of prayers and hugs,

> > > > 

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

[Guest guest]

a,

I don't mind answering questions. The typing isn't too bad with the

new keyboard. I have been on Enbrel and Imuran for 2 years now. I

have tried just about everything there is to take for RA. Actually

the best results I had were with methotrxate but with elevated liver

enzymes I could no longer take it. The joint replacements helped

with the gross deformity but it did nothing for the subluxing or the

ulnar shift. I have never been to the Mayo Clinic or Hopkins,

but I do go to UCLA Med. Ctr. One of the reasons my RA is so bad is

due to the fact I went 9 yrs without seeking treatment. At first I

was in denial and then I assumed it would go away on its own. Like

so many other people out there, I was fixated on the word arthritis.

Once I figured out the extent of the disease I decided to seek

medical treatment for it. I don't know what treatment course my new

doctor has in store for me yet. I'll know on my next appt. Thank you

for the offer. I am always looking for new information on RA and

meds so I can be informed when I see the doctor.

> > >

> > > > I am sorry for not clarifying this new stage. According to

the

> > > >  American College of Rheumatology, RA is classified into

four

> > stages:

> > > >

> > > >  Stage I-early: 1)No destructive changes on Xray Exam

> > > >                

2)Evidenidence of osteoporosis may

> > be present

> > > >

> > > >  Stage II-moderate: 1)Xray evidence of osteoporosis, with

or

> > without 

> > > >  slight bone destruction; slight cartilage may be present

> > > > 

                 Ã

‚  2) No joint deformities

> > although limitation of

> > > >  joint mobility may be present

> > > > 

                 Ã

‚  3) Adjacent muscle atrophy

> > > > 

                 Ã

‚  4) Nodules and

> > tenosynovitis may be present

> > > >

> > > >  Stage III-severe: 1) Xray evidence of cartilage and bone

> > > >  destruction, in addition to osteoporosis

> > > > 

                 

2) Joint deformity such as

> > subluxation, ulnar

> > > >  deviation, or hyperextension, without fibrous or bony

ankylosis

> > > > 

                 

3) Extensive muscle atrophy

> > > > 

                 

4) Nodules and tenosynovitis

> > may be present

> > > >

> > > >  Stage IV-terminal: 1) Stage III criteria

> > > > 

                 Ã

‚  2) Fibrous or bony

> > ankylosis

> > > >

> > > >  I have severe subluxation and ulnar deviation on both

hands and

> > > >  feet. I also have osteoporosis and cartilage & bone

destruction;

> > > >  nodules everywhere, muscle atrophy, and fibrous ankylosis

on

> > both

> > > >  kidney and liver.

> > > >  I hope this clears a few things up. The website to go to

is

> > > > http://www.hopkins-arthritis.com/index.html

> > > >

> > > >  Lots of prayers and hugs,

> > > > 

> > > >

> > > >

> > > >

> > > >

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[Guest guest]

a,

I don't mind answering questions. The typing isn't too bad with the

new keyboard. I have been on Enbrel and Imuran for 2 years now. I

have tried just about everything there is to take for RA. Actually

the best results I had were with methotrxate but with elevated liver

enzymes I could no longer take it. The joint replacements helped

with the gross deformity but it did nothing for the subluxing or the

ulnar shift. I have never been to the Mayo Clinic or Hopkins,

but I do go to UCLA Med. Ctr. One of the reasons my RA is so bad is

due to the fact I went 9 yrs without seeking treatment. At first I

was in denial and then I assumed it would go away on its own. Like

so many other people out there, I was fixated on the word arthritis.

Once I figured out the extent of the disease I decided to seek

medical treatment for it. I don't know what treatment course my new

doctor has in store for me yet. I'll know on my next appt. Thank you

for the offer. I am always looking for new information on RA and

meds so I can be informed when I see the doctor.

> > >

> > > > I am sorry for not clarifying this new stage. According to

the

> > > >  American College of Rheumatology, RA is classified into

four

> > stages:

> > > >

> > > >  Stage I-early: 1)No destructive changes on Xray Exam

> > > >                

2)Evidenidence of osteoporosis may

> > be present

> > > >

> > > >  Stage II-moderate: 1)Xray evidence of osteoporosis, with

or

> > without 

> > > >  slight bone destruction; slight cartilage may be present

> > > > 

                 Ã

‚  2) No joint deformities

> > although limitation of

> > > >  joint mobility may be present

> > > > 

                 Ã

‚  3) Adjacent muscle atrophy

> > > > 

                 Ã

‚  4) Nodules and

> > tenosynovitis may be present

> > > >

> > > >  Stage III-severe: 1) Xray evidence of cartilage and bone

> > > >  destruction, in addition to osteoporosis

> > > > 

                 

2) Joint deformity such as

> > subluxation, ulnar

> > > >  deviation, or hyperextension, without fibrous or bony

ankylosis

> > > > 

                 

3) Extensive muscle atrophy

> > > > 

                 

4) Nodules and tenosynovitis

> > may be present

> > > >

> > > >  Stage IV-terminal: 1) Stage III criteria

> > > > 

                 Ã

‚  2) Fibrous or bony

> > ankylosis

> > > >

> > > >  I have severe subluxation and ulnar deviation on both

hands and

> > > >  feet. I also have osteoporosis and cartilage & bone

destruction;

> > > >  nodules everywhere, muscle atrophy, and fibrous ankylosis

on

> > both

> > > >  kidney and liver.

> > > >  I hope this clears a few things up. The website to go to

is

> > > > http://www.hopkins-arthritis.com/index.html

> > > >

> > > >  Lots of prayers and hugs,

> > > > 

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