This is getting ridiculous...

Diseases & Conditions Rheumatoid Arthritis
1
Okay..Wed. I went to the long awaited Rheumy appt. for this knee pain. First thing, nurse takes vitals and asks me "Do you have an irregular heartbeat"? Well, no.. but according to two nurses and the rheumy I do. Oooookay. Now that I'm totally freaked out.. he comes in the room. He bends my elbows back and forth, tells me I have a good stretching program. He looks at my hands, turns them over looks at my palms. Tells me from THAT that I do not have lupus or RA. Tells me since i'm on narcotics, he wont' treat my fibro.. (gee, I take lortab for my knees and my back..not fibro). Then says my knees arent swollen, it's skin discoloration from smoking. Uh huh. He moves them maybe an inch.. says he sees absolutely nothing wrong with them. He orders MRI, then says he'll send me to ortho when the results are in. Not one drop of blood did he draw. That's all he did. Ten minutes tops.
So Thursday.. I go to my PCP. You should have seen his face getting redder and redder as I keep talking. He listens to my heart for a LONG time, even the pulses in my arms and neck. Told me I have absolutely not a thing wrong with my heart rate. He kept repeating.. he looked at your HANDS??? There was a lot of eye rolling going on, too..lol.
Soo.. he drew the blood panel the rheumy should have. He agrees with my plan, do the MRI.. go back once for results take my referrel to ortho.. then never go back. Doc said if he wont' refer me to ortho.. come back and he will.
So how ridiculous was that visit? All I've heard is how good rheumy's are at finding problems, and how much blood they draw.. and this one didn't do a darn thing for me.
ARRRRRGGGGHHHHH!!!!!
Sarah

I'm not procrastinating----I'm still doing yesterday!!!! 
I have no medical training, any medical opinions expressed in my posts are just that....opinions.

2

Sarah,

Your visit sounds like it was very frustrating.  I'm not a rheumatologist, but looking at the hands is an important part of the appointment.  But only a part.  You cannot tell if an individual has lupus or RA, or any other CTD without bloodwork.  I had a similar experience with a GI doctor.  I told her I had RA, and she grabbed my hands, looked at them for 5 seconds, and said you do not have RA.  I informed her I had a positive RF, and she shut up real quick.  Diagnosing these diseases is very tricky and it takes a good, solid physical exam, a detailed history from an expert interviewer, and lab tests to actually come to a diagnosis.  My first rheumy visit was about 45 minutes long.  The longest I've ever sat in a doctor's office.  Good to know that you have a good PCP.  I like your plan.

Elcamino

Current dx: Rheumatoid Arthritis
Suspected dx: Early Lupus/MCTD; Inflammatory Bowel Disease
Current Meds: Enbrel, Plaquenil, Aciphex, Ultracet, Zyrtec, Allavert-D, Zantac, Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan

3
Sarah
I think you should find another Rhuemy. My first one did do some blood work and some xrays. he spent about 15 minutes per visit (I saw him 3 times) and in the end told me I fibro and nothing else and on the 3rd visit told me he had done all he could (He is even an associate professor of rhuematology at a state medical school). The second rhuemy did all the blood work he did again and then some plus a host of other test and found many things including arthritis and bone spurs in lots of places. the first visit she moved every joint in my body to feel how it was working (My first and second visits were about an hour each). Not all doctors or rhuemys are alike and some of them make their decesions to fast just like the rest of us. Unfortunatly when they do that we pay. You know something is going on with your body and you need to keep looking till you find a doctor who will look hard enough to help you. You are as always in my prayers.

Mark

PS
Could be that he just thinks your short
(couldn't resist) hehehehe

We make a living by what we get; we make a life by what we give.
Sir Winston Churchil
 
A cheerful heart is good medicine,
but a crushed spirit dries up the bones.
Proverbs 17:22

4
Hey there Sarah - You know... some docs really know how to P*&S us off don't they? I'm sorry your rheumy was a "poopie-head" (hee hee hee). The bright side? Your PCP sounds like he knows what he is doing. Maybe he could refer you to a different rheumy? Ah, the frustration of all of it is enough to make a person batty.. hang in there, we're here for ya! Duck

Confirmed Diagnosis of - Psoriatic Arthritis/Spondylitis/Graves Disease/GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes/Chronic UTIs
Current Meds -  Enbrel/Prevacid/Synthroid/Nitrofurantoin
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots
Additional Supplements - Multi-Vitamin/Bromelian/Acidophilus/Green Tea

5
Sarah I do have to agree find another Rheumatolagist because the one you are seeing need's to go back to school.The first Rheumt that I seen was wounderful she bent me every wich way and did blood work.The first time I seen her iwas so swollen up that I so in so much pain and her first word's to me was oh my god.When my blood work came back she called and asked for me to come back in and it turned out I tested posative for RA(my Dad has RA)so it didn't supprise me at all.Well my ex-husband got transfered and I again got lucky and got a wounderful Rheumy by this time I was having severe pain in my lower back and my left knee was poping like crazy and she did some more test and blood work and it was found that not only did I have CROHNS,RA I also had OA as well.Now moving on I and my ex got devorced and I moved back to my home town (been gone for 24 years)I was sent to see this Rheumy(a man) this time and he was about as werthless as they came.I mean here I was with all of my files for him to read and see what has been done so on.Well he could not make up his mind if he was going to stay here are go back to New York.I got my PCP to find me another Rheumy and my PCP told me there was not another one that my Insurance would let me see I beged him to find me an Internest and it just so happen's that my Dad's Rheumy told my Dad to have my PCP to call DR.Winn and he did and she agreed to take my insurance I was so relived.I love her she has been wounderful to me and is so understanding as well and I would not trade her for any thing.The only draw back that I have is if I need blood work done I have to take the order and let my PCP do the blood work because my insurance will not pay for me to have my blood work are ex-ray's done there at her office.The point being that there are good one's out there some times we have to go through a few before finding another.Since I have been seeing this Rheumy it was discoverd that I as well have AS.I carry a gen called HLA-B27.W hen you find another Rheumy asked that you be tested for this gene because most people with this gene have RA,AS OS as well.It is a heretatery (sp)in turn means that one parent is a HLA-B27 possative.I do hope that you get every thing worked out I know it can be very frustrasting but you will find a better Rheumy and you will get on the right track.

Thanks
Curley......
a.k.a.Mela...........

6

Thank goodness you have a great PCP. Do as directed and find another rhuemy in your plan to have ready to see when the time is right. An ortho and MRI is great as well. Good luck

**

 

7

Hi Sarah,

     I had alot of trouble with my first rheumy, said once the insomnia gets under control the pain from the fibro would go away! Ha!  He said I could not work any longer but that "he was not the guy to send the SSD paperwork to"  I am now seeing a new rheumy, she checks all my joints for swelling, knots and motion.  Come to find out I have RA, polyarthritis and Osteo!  My RH factor is on the borderline, but she said by her physical examination that I do have RA.  She placed me on methotrexate and plaqunel.  If I do not improve by the next visit then she will start me on Enbrel or Humira.

     Good luck to you Sarah, hope you find a good rheumy soon.  I know you have been suffering for a while.  I usually chat with you in the fibro chat.

Take care of you,

Tee

 

 

Trust in the Lord with all your heart, And lean not on your own understanding; In all your ways acknowledge Him, And He shall direct your paths.  Proverbs 3:5-6
 
Dx: Fibro, RA,Osteo Arthritis,  Polyarthritis, Asthma, IBS, Migraines, TMJ, Insomnia, Ischemic Colitis, Mitral Valve Prolapse, Vasovagal Syncope, Low Blood Pressure, Allergies, Bladder etc...
 
 
 

8
awe, don't get discouraged. this happens all too often. hey, you were lucky the MD even LOOKED at you! LOL. they don't see the RA or any AI or inflammatory process going on...so they brush you aside quickly. this doesn't mean that the next rheummy will do the same. your PCP seems like he's on your side & a good advocate; he might be able to treat many of your problems for now. take a referel for another specialist.
you're not alone with this one...so many people will relate to it trust me.
erin

Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.

9
Hey Sarah, how's it going? Have you gotten your results yet? Have you decided what you are going to do? Hope all is well.. rest easy and take care... Duck

Confirmed Diagnosis of - Psoriatic Arthritis/Spondylitis/Graves Disease/GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes/Chronic UTIs
Current Meds -  Enbrel/Prevacid/Synthroid/Nitrofurantoin
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots
Additional Supplements - Multi-Vitamin/Bromelian/Acidophilus/Green Tea

10
Okay, I got my MRI results today. But what exactly the issue is isn't clear. The MRI showed nothing but joint effusion. So there is fluid in there for SOME reason or another. Other than what is supposed to be. The rheumy can't figure it out. At least now I know why I feel this constant pain and pressure in there.
My rheumy went from Mr. Hyde to Dr. Jekyll.. he was the nicest person today. Weird. He wants results of my blood tests from PCP faxed to him, along with my last back xray. I go tommorrow to PCP so I should know something a little more.
I did get clarification on the not treating me for fibro. He meant that since I'm already on lortab and other meds, and have a good stretching program... there isn't anything else he can do. I'm already doing it. So he wasnt being a total jerk. He just didn't explain it properly. He still stands by no RA or no Lupus. So I'm still in limbo as far as the cause of the fluid. Maybe the blood tests will show up with some type of something. It's a bad day when you hope your tests come back ABnormal, isn't it?
Thanks for all the replies, and the good wishes, and I will update as I know it.
Sarah

I'm not procrastinating----I'm still doing yesterday!!!! 
I have no medical training, any medical opinions expressed in my posts are just that....opinions.

11

hey Sarah,

no, it's not bad.  and believe it or not...doctors want positive bloodwork and abnormal crap to show up as well!  nothing is more frustrating to a pt and an MD as a difficult-hard-to-crack treasure-hunt-case where there is no BOOM THERE IT IS IN YOUR FACE clinical findings.

Dr's like textbook pts.  few like to put the energy into the search.

so the twisted as it may seem feeling of "the want for abnormal" is...TOTALLY NORMAL.

especially if there are things going on that don't exactly make sense or are odd. or rare. and autoimmune and rheumatics?...geesh, GodBless people going into that specialty.  i mean, look at how complicated it is!  to us! 

so, in all...validation for what is wrong is kinda like....closure.  and Sarah, it may take a lot of time. but if they are finding things & this doc is acting differently, you're in the right direction.

in my prayers.

sincerely,

erin

Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.