New Member - PsA or RA?

[Guest guest]

Hi all,

I am a 47 y.o. woman with a hx of very mild and intermittent P on my

knuckles and elbows for as long as I can remember, developing toenail

onycholysis and onychodystrophy as an adult. Increasing osteoA

diagnosed over the years in lumbar spine, cervical spine, hips and

feet. Bursitis in hips and shoulders. Intermittent use of Celebrex

for relief of hip pain. Maternal grandmother had severe RA. 2007

was going really well until two months ago when, in the midst of

selling and buying houses and moving, when physical exertion and

stress were running high and the weather was warm and humid, my hands

became swollen. After a week or so I could no longer attribute the

swelling to the weather and physical exertion – my toes were swelling

too and fingers and toes were beginning to feel stiff so, at week 3,

I saw the rheumatologist I had seen summer 2006 for a 5 week-long

serum sickness-like reaction to a migraine medication. The doc

ordered all the right blood work and x-rays of hands and hips and I

started Celebrex for hip pain. Test results all came back neg/normal

except for slightly elevated CRP and signs of osteoA on hip x-rays.

By week 7, hands, wrists, lower back and feet very painful.

Everything symmetrical. Using wrist splints as needed. Hip pain

better with Celebrex. Saw doc week 7. Repeat blood work showed no

changes but CRP a little higher. Started methotrexate. 10 mgs week

8, 15 mgs week 9, 15 mgs week 10 (yesterday). Symptoms still

worsening, not improving. Swelling insignificant but stiffness just

as bad and pain much worse. Ankles and maybe knees becoming

involved. Waking up like a 110 year old and then range of motion and

pain improving throughout morning with activity. Anxious about

whether I should be doing combo of methotrexate and biologic to guard

againt permanent damage but doc (by phone yesterday) reassures me

that I have caught this so early that it is safe to wait and see

whether the methotrexate works alone. Next appointment in two weeks

(week 12). Doc is leaning toward dx of PsA rather than RA based, I

think, on my hx of P and apparent sacroilliac involvement.

Thoughts? Comments?

Thanks,

Liz

[Guest guest]

Liz, sounds like your rheumy is proceeding normally. I would trust

him and see what happens as time progresses. He will give it more

time and then add biologics if needed. It does take up to 12 weeks

for MTX to show significant improvement.

For what it's worth, my PA came on suddenly (with no prior diagnosis

of P) and progressed rapidly and symmetrically as yours did. I was

virtually bed-bound for a few months until the MTX started to kick

in. Eventually I had to switch to a biologic (Humira) because my

liver didn't do well on MTX.

You are very blessed to have gotten in to see the rheumy quickly and

to have gotten a PA diagnosis so quickly. As your Dr. said, you

should not suffer any permanent damage, and you should be able to get

pain relief once the right med or med combo is found.

Don't panic. This is usually controllable; though none of us would

have chosen to have PA and would welcome a complete remission, most of

us have found it not to be so tragic as we once imagined.

best regards,

sherry z

>

> Hi all,

> I am a 47 y.o. woman with a hx of very mild and intermittent P on my

> knuckles and elbows for as long as I can remember, developing toenail

[Guest guest]

LIZ, HI. I HAVE PA AND LUPUS. I'M ON PLACQUENIL 200MG DAILY. THAT CONTROLLED

ME WELL UNTIL THIS YEAR. I'VE BEEN ON MTX FOR 20 WEEKS NOW. I HAD AN INITIAL

RESPONSE TO THAT AND NOW IT HAS LEVELED . I'M TOLD THAT THAT WILL HAPPEN SO I'M

HOPING TO SEE MORE IMPROVEMENT SOON. IT SEEMS TO ME THAT YOU SHOULD HAVE SEEN

SOME IMPROVEMENT HOWEVER THERE ARE DIFFERENT MEDS THAT CAN BE USED IF MTX

DOESN'T WORK. ARE YOU STILL TAKING NSAID? GOOD LUCK, I HOPE YOU FEEL BETTER

SOON. MARYLOU

MARYLOU

[Guest guest]

Sherry,

Thank you so much for your reassurance and for sharing your hx; I

wake up every morning and rediscover my developing symptoms and get

fearful that it will never get better. This morning was no different

and it was great to read your response. I am again blessed.

I am hopeful that eliminating alcohol will protect my liver, but I

actually forgot last week when out with friends and drank half a beer

before the light bulb when off in my head.

Everything is new and so tiring. My sleep patterns are a patchwork.

One day at a time!

Thanks again,

Liz

[Guest guest]

lou,

Thank you so much for your response. When you say leveled, do you mean

that the improvement stalled but that your symptoms did not worsen? I

had not heard of this and am glad to be forewarned so that I don't get

too pessimistic if this happens. I am still taking Celebrex. Trying

to figure out what I can take on top of that for a headache that

started yesterday; my doc told me to double up on the Celebrex if

necessary but I don't know if that would help (or be appropriate for) a

headache!

Thanks again,

Liz

[Guest guest]

Try aspirin free extra strength Excedrin. I use it all the time. It's marketed

as their " Tension Headache " formula. It's actually acetomenaphin (tylenol) with

80mg of caffeine. Don't know why but my doctor told me that double blind

studies have shown that the caffeine helps acetomenaphin work better. I was in

the hospital with an infection a year ago that had me with temps up to 103 and

they gave me tylenol for two days with no results. Finally, the headache I had

from the fever was so bad, I got in my purse and took two of my own excedrin.

Within one hour, my headache was gone and so was my fever!!!!! I could take an

entire bottle of extra strength arthritis formula tylenol and it wouldn't do a

thing for me.

Joanna Hoelscher

630-833-7361

[Guest guest]

Liz - I was where you are not that long ago, fearing I would never

have any semblance of my old life back. PA is not fun, but I found

that it doesn't have to ruin your life!

Have you tried any of the non-alcoholic beers? They do have a

*tiny* bit of alcohol, but very minimal. Some of them are great.

My favorite is Kaliber, made by Guinness. And there are some other

really good imported ones, Bitbeier for example. Also, the O'Doul's

AMBER one is nice. (I like dark beers best.) Now that I'm off MTX,

I'm allowed to have some beer and wine again, but I still drink the

non-alcoholic beer because it's so low in calories and tastes just

as good to me! The Kaliber has only 70 calories in the whole

bottle. Some brands are as low as 50 calories.

By the way, the " patchwork " sleep patterns are also typical with

PA. Many people use prescription sleep aids in fact. Now that I am

doing so much better, my sleep is more regular but not the old

normal. The last 2 weeks I wake up about every 2 hours, but I'm

able to go right back to sleep - yes, my pain is THAT MUCH better!

At worst about a year ago, I could only sleep in 30-45 minutes

stretches and was up at least once each night for 30 minutes to 2

hours icing down joints (and crying)! If your sleep is too

disrupted, ask for help from your Dr. There are newer better sleep

aids these days.

best regards,

sherry z

[Guest guest]

LIZ, HI. SORRY I DIDN'T EXPLAIN MYSELF BETTER. YOUR RIGHT THE IMPROVEMENT

STALLED BUT I DIDN'T GET WORSE. I WANTED TO MAKE SURE TO TELL YOU THIS- IT'S SO

EASY TO GET DISCOURAGED AND PESSIMISTIC. I FOUND THIS OUT BEFORE I STARTED THE

MTX FROM A FREIND WHO USES IT FOR RA. THAT'S ANOTHER POINT-MANY OF THE MEDS FOR

AUTOIMMUNE DISEASES OVERLAP. BY THAT I MEAN THAT MED MAY BE ADVERTISED AS USED

FOR _____, BUT MANY TIMES CAN BE USED FOR ANY AUTOIMMUNE PROBLEM. AS FOR

HEADACHES MINE WHEN ALLERGY SEASON IS IN BLOOM I RELY ON ANTIHISTIMINES.BUT I

WILL GET HA FROM INFLAMATION WHEN I'M HAVING A FLARE AND THEN I USUALLY HAVE TO

TAKE AN EXTRA NSAID OR INCREASE MY PLACQUINIL TO TAKE CARE OF THIS. I HOPE THIS

MAKES SENSE. TAKE CARE AND I HOPE YOU FEEL BETTER. MARYLOU

[Guest guest]

non-alcoholic beers are a great idea. i prefer weaker beers than you

so maybe i can get away with the 50 calories! last night someone

bought and handed me a corona. i took two sips and then handed it

off to a grateful soul! i hadn't even thought about sleep aids. i

will discuss with doc at next appt. thanks.

[Guest guest]

antihistamines will help me sleep too, lol. i take singulair for

asthma so will have to check with doc. thanks again marylou.

[Guest guest]

joanna, going straight out to get the excedrin! can't believe i've

head this headache on and off for days now. will let you know . . . .

liz