Still in shock and not quite sure what to think...

By StacyR Tuesday, January 17, 2012

For starters I have to say thanks to the folks out there making this site happen. I am as about as lost feeling as I think I can be, and all your words are truly helping me cope.

 

My short story...4 years ago I made the life changing decision to have a roux-en-y Gastric bypass. I changed my eating habits, began exercising regularly, and 135lbs later I am (well, was) in the best shape of my life. At 38 yrs old, I was running half marathons, weight lifting regularly, playing co-ed indoor soccer every week, and pretty much loving life. I'm the mom of a fantastic 8 yr old girl, and cannot imagine not being the active woman she knows.

 

About 9 months ago I started feeling tired alot. At first I thought it was stress (a divorce, promotion at work, etc) and then ended up testing positive for severe anemia. In the mean time, every once in a while one of my fingers would bother me, which I attributed to breaks during sports in my younger years. Also, I had shoulder pain (just one side) but was writing that off to potentially overdoing it while lifting weights.

 

Then, right around Thanksgiving, my knees started barking. One morning after a Sunday night soccer game, I woke to a severely inflamed knee. My primary care send me to an orthopedist, who after an MRI and some failed cortozone shots, decided a knee scope was in order. In the meantime, just prior to that surgery, my other knee blewup and I started having major problems with the IT band on that leg. The left shoulder started waking up as well, but these things were written off to "compensation" for the right knee. As for the anemia, that doc gave me infed iron to boost my counts.

 

I ended up having the knee scope just after the 1st of the year. In the last two weeks, my joints in my big toes, the knees, shoulders, elbows, and 6 fingers,  have all become inflamed/severely swollen. This landed me in the ER, where they did some preliminary bloodwork and found my CRPs were up as well as my Sed rate (?) was high. That was a week ago...when they put me on Percodan and recommended a rheumatologist. I saw my primary care (she ran the bloodwork the rheumatologist will need) and she's told me to prepare for the real possibility that I have RA. My mom has it, and the signs seem to be pointing that way.

 

I HAD NO IDEA that RA is what it is. Like most of the world, my ignorance led me to believe that it is just another arthritis thing and that the right pain meds would fix it. Now, as I lie in bed typing because I simply do not have the strength to get up, I am in shock an searching for answers. My appointment is two days away, and at the rate things are progressing (it seems a new joint joins in the chorus each morning), I'll be in a wheelchair by then.

 

I'm a fighter...heck, I lost a person's worth of weight and reshaped my way of living entirely. This, however, has me beat at present. I am looking for help as to what to ask this new doctor when I see him in a couple of days. How long should I keep taking the pain meds? Is it normal to feel like they aren't really working now (other than to settle me down mentally)? I obviously don't have a diagnosis yet, but I have zero rashes, fevers, etc. and my mom has very mild RA, so we will see.

1/17/12 12:34pm

Hi Stacey

 

So sorry to hear of all this. Unfortunately it is a well trodden road for me and many others.  It is a hard road, but as you say, you are a fighter and that will be important.

It is good that your bloodwork is giving a clear indication of what the problem is likely to be. Some people do not have positive blood results and yet still have the disease and it takes longer to get a diagnosis

 

If you do have ra, It is normal for the pain meds not to work well at first, pain levels in ra are hard to control at first.

 

There are many drugs out there for this condition and it is a bit of a journey to get the right drugs. Some people have more success with this than others, I do hope you are one that finds the easier path.

 

Take a list of your questions to the doc and don't be afraid to ask them

 

Some docs will give you a firm diagnosis the first time and some won't, if he doesn't, then ask him what other diagnosis are possible with your symptoms

 

Ask for better pain relief, I was slow to do this and went too long without adequate pain relief. Some pain meds work better for different people. I am about to change mine as they seemed to have stopped working.

 

Many docs let you choose which meds to take for the control of the ra [this is a big subject, check this site for info on biologics and other ra meds], I try to get their opinion as to the best one. Get info on the side effects of drugs, this can be offputting as some of them sound terrible and can be terrible, but compared to the possible results of ra if it is unchecked, they are better.

 

Having said all this, keep your hope up, you are not yet diagnosed and if you are, there are many of us living with this and you will have friends and good information to help you

 

 

1/17/12 4:15pm

Thank you so much for the kind words!!! I am armed with my list of questions - but I have to say so many are being answered poking around these forums. I am looking forward to learning more,

1/17/12 6:09pm

I wish I had discovered this site sooner, it is a great help

 

Lene Andersen, Health Guide
1/18/12 12:51pm

I'm sorry this is hit you so fast and so hard. RA is indeed about much more than just joints and the fatigue especially really kick your butt. As I write this comment, I'll include links to helpful articles that give you more information.

 

There are some good news in all of this. You have a PCP who's on the ball and you're seeing a rheumatologist relatively soon after the start of your symptoms. That means your prognosis has a big help to be better. The sooner you get a diagnosis and start medication to suppress your RA, the greater likelihood there is that you will have a better outcome. Also, treatment options these days are much better than they have ever been - it is now possible to experience remission. Not all people with RA go into remission, but many get their disease suppressed so far that they can lead a fairly normal life. I know of people who still run marathons, kickbox, play recreational soccer, work full time and all the rest that goes into a life. There is hope, more hope than there ever has been before. The key is early and aggressive treatment.

 

Right now, you are in what sounds like a massive flare. Likely, the rheumatologist will prescribe you medications to suppress this. They may prescribe prednisone, which can be an excellent help to deal with symptoms and bridge you until other types of medications kick in. They will likely also suggest methotrexate, which is the gold standard for RA and often the first medication that is prescribed. Methotrexate is an immune suppressant and usually takes 6-8 weeks to kick in.You may experience side effects such as fatigue and some nausea for couple of days after you take it, but there are ways to manage side effects.

 

In terms of the pain meds - percodan is an opioid that deals with pain. However, it doesn't deal with inflammation and that could be why it's not working as well as you'd like. Also, you can expect take some form or painkillers or anti-inflammatories at least for the present until the medication for your RA starts working. It is also possible that you may need to take them on a continual basis, although if you do go into remission, you may be able to take milder form of painkillers and keep the opioids for bad days.

 

We have a couple of posts that can help you in terms of your appointment. Check out our basics of RA area for information about the disease. As well, we have posts on preparing for the first appointment with a rheumatologist, as well as signs that your rheumie is a good one. You may also want to check out my post on self advocacy for tips on how to be proactive and take charge of your medical care. When/if you get a diagnosis, you may also want to read my post for people who are new to RA - it collects links to other information in our archives that can help you with almost all aspects of living with RA.

 

You are very obviously a fighter and have experience in fighting long battles and that's going to work for you. Living with RA is challenging, sometimes hard like nothing else you've ever done, but living well with this disease is possible. I've had it since I was a child (over four decades now) and can tell you from experience that there are times where it will take up a lot of room in your life, like it is doing now, but other times where it will simmer away on the back burner like it's supposed to. You still have a life and you will be able to live it.

 

hang in there, it gets easier. We are here to see you through. Please let us know what happens in your appointment?

1/18/12 9:31pm
Thank you so much for all the wonderful info! It seems like I've spent ALOT of time researching this and everyday turns up something new. I appreciate the links more than you know and will post as soon as I hear what the diagnosis is. God bless!!!!
Lene Andersen, Health Guide
1/18/12 9:56pm

you're very welcome. Anything we can do to help!

1/19/12 11:36am

Hi Stacey, I know its hard when your not sure what is going on and why and if its RA or something else.  I got lucky, my first rheumy was great, had to switch rheumies when I moved 100 miles away and it was too far for me to drive as I have RA really bad in my shoulders and my car is a stick shift.  The one I have know is good also, I just liked my first one better as he was more personable.  It took a while to find the right meds for me, but I finally did and it has paid off, my RA is in remission and that is a great feeling.  I still have bad days with pain and some days with no pain.  The first thing I would say is try the medications the doctor suggests to see if they work and don't worry about the side effects as most are mild and some go away after you have been on the medication and your body gets used to it.  I know about staying in bed all day because you are tired and sore, just remember to keep moving don't push yourself too hard, especially if the RA is flaring, but remember exercise is good for the joints also.  You put a question next to your Sed rate that test tells how much swelling is in the body and until you can get it down that could be why the percocet isn't working.  I would ask the doctor, if he says you have RA, what the various test are called and what they mean this will help as you will get to know what is normal and what is high and don't be afraid to ask about your test results.  Remember to always write down your questions for the doctor, as more will come up and don't leave until he/she answers them.  Also, it may be a good idea to start a pain journal, every day record how bad the pain is, where you are in pain and if there is swelling, ect.  This way you can share this with your doctor as he/she will need to know this in order to help you and help you control the disease.  Hope today's appointment goes well and remember, there are a lot of us out there who know what you are going through.  My daughter was 7 when I was diagnosed, shes 17 now and has been a big help when I cannot do things and has grown up to be a strong woman herself.  It was hard not always being able to do what I wanted to do with her because of the RA, but we both survived.  Your daughter will be fine, just don't shut her out, let her know what you have and let her know that there are going to be days when because of the RA you can't do things you normally would do.

1/21/12 1:50pm
Thanks so much for your reply!!! The appointment went well. I don't have a clear diagnosis yet (waiting on the bloodwork) but the X-rays show no joint damage in the hands and knees which was great news! He did see something with the spine and sent that to a colleague for review, so it will be a couple more weeks before we have a definitive answer. In the meantime he prescribed Prednisone at a super low rate once a day. This is day three and it does seem to be reducing the swelling. I let him know immediately that I don't want that long term and he agreed! He said we got it early and really just need the bloodwork back so we aren't shooting blind with treatment. I appreciate what you shared about your daughter! That has been a huge weight on my conscience- she's such an empathetic kid already, and she had been amazingly helpful. I think she likes helping tie my shoes and opening bottles for me :) I will keep y'all posted - you are each a blessing!!!!
1/23/12 11:10pm

Well, I went in today to my rheumy due to stomach complications from the Prednisone and learned that I do indeed have RA. We've stopped the steroids and have a upper endoscopy scheduled for February 3rd just to be safe, and I'll start methotrexate just after. I'm sure I'll have lots to say about this over the next few weeks - so thanks to all for listening!!!!

1/24/12 1:15am
So sorry to hear that you do have RA. I wish you the best in finding the right medication to beat this. I am waiting to see the rheumatologist to find out if what I have is RA, so I feel we are on the same path. I am 38 and have a 7 year old daughter and 4 year old son. I also was very active working out - I would do Pilates 3 times a week, so I also attributed some of pain to too hard of a workout. Looking back, I wish I had listened to my body more, but I feel I went fairly early to the dr to try to find out what is wrong with me. Just wanted you to know that someone was going through something similar and I am wishing you the best. This website is so helpful - I am sure you have been poring over it like I have been. Take care, Jen
1/25/12 8:51pm

Thanks so much for taking the time to reply!  My best to you in finding your diagnosis. You will be in my prayers.

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By StacyR— Last Modified: 01/25/12, First Published: 01/17/12