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Medical Forum / Diseases and Disorders / Arthritis / April 2006In a bit of a state
Hi, This is my first post to this newsgroup. I'm a 43 year old male living in the UK. I've just been to my GP this morning and he has sent me for some blood tests to look for RA. Last year I was diagnosed with cancer (hodgkin's Lymphoma) and the treatment went well. I finished the chemotherapy in January this year. For the past few weeks I've had pain and stiffness in my hips and knees, and for the past week I've also had it in my fingers. Sometimes when I wake up in the morning I cannot move my fingers at all and then after five-to-ten minutes they free up and I'm OK. I also have some pain in my back and shoulders. After driving 20 miles or so I have difficulty getting out of the car. I thought it might be a delayed side-effect of the chemo but my doctor doesn't think so. I'm due to go on a long-waited holiday in a week's time, so I intend to just go and then contact my doctor for the blood resluts when I get back. If it does turn out to be RA then my GP says he'll refer me to a rheumatologist. I always thought that RA was a slow-moving degenerative desease, so my question is - can RA really develop that quickly - from feeling OK one week to having all sorts of problems the next? Thanks, Jeremy. >I always thought that RA was a slow-moving degenerative desease, so my >question is - can RA really develop that quickly - from feeling OK one >week to having all sorts of problems the next? It can develop very quickly and it can disappear and reappear abruptly. Some people develop it slowly unfortunately it is often unpredictable. The good news is they have some excellent treatments these days. Welcome to the group I hope you have good news from your tests and it is not RA. Hi Jeremy. I, too have RA as well as Fibromyalgia. From what I've read and seen here, RA is usually a slow degeneration, although others may tell you differently. I'm glad you're still going on your trip - have a great time, and you can begin where you left off on your return. Nanny > Hi, > [quoted text clipped - 24 lines] > > Jeremy. Hi Jeremy, A quick answer is yes. There are reasons that this happens though and it is the reason we continue to see our RDs even though we feel pretty good. High stress can trigger our immune systems to kick into high gear for one reason and there are many more and it is the reason the RDs make the big bucks. Harv > Hi, > [quoted text clipped - 24 lines] > > Jeremy. Hi Jeremy - I remember how shocking it was to hear RA as the cause of my various aches and pains when I was finally diagnosed. Even if the RF test comes back negative, you can still have RA so let the doc explain the whole set of tests to you. Your doc will combine all the blood tests and your symptoms together to decide if you have RA for sure. It's a disease that comes and goes for some. For others it sets up permanent housekeeping. One thing I did want to mention to you is that as a side effect of Chemo you can get something called Osteonecrosis. It's cause the same kind of pain as RA in various joints. It can be seen on xrays and is caused by poor blood supply to the bones. Did you ever take any form of cortisone or steroids with the chemo? It would put you at higher risk for ON. ON is not something drs thing of too often especially if they are not the dr treating you. Let me know if you need any addition info on Osteonecrosis and I will send you some or you can just google it. Good luck! DiW Thanks for all the replies so far. > DianeW wrote: >> Did you ever take any form of cortisone or steroids with the chemo? Yes. I took a steroid called Dexamethasone, I'll have a look at Osteonecrosis and, depending on my blood results, I might mention it to the doc. Thanks. Jeremy. > Thanks for all the replies so far. > [quoted text clipped - 9 lines] > > Jeremy. Osteonecrosis can't be seen readilly on x-rays until it's advanced and there is either collapse or a very obvious fracture. MRI is the only definitive diagnosis. Bone scan doesn't rule out a type of osteoporosis, so MRI is the way to go. I got osteonecrosis before the corticosteroids used during immunoablation therapy (similar doses to those given with chemo) and despite having fractures all through the femoral head it did NOT show up on xray. The hip was shattered and disintigrated in the surgeon's hands when he squeezed it upon removal. After the MRI the severity of the damage was readilly seen and my first hip replacement was performed not long after. Regards, Ari  Signaturespammage trappage: remove the underscores to reply I'm going to die rather sooner than I'd like. I tried to protect my neighbours from crime, and became the victim of it. Complications in hospital following this resulted in a serious illness. I now need a bone marrow transplant. Many people around the world are waiting for a marrow transplant, too. Please volunteer to be a marrow donor: http://www.abmdr.org.au/ http://www.marrow.org/ Well, taking steroids definitely puts you at a higher risk for ON. That's what supposedly happened to Bo Jackson from all the steroid injections in his joints. Could just be a rumor but that's what I was told. Avascular Necrosis is the old school name for it. I have both RA and ON so even if the blood tests are positive for RA you might want to mention it to him anyway as you can have both. If you carry the Factor V Leiden gene mutation (FVL) , you are at even a higher risk for it. Same with high cholesterol. Have you ever had a blood clotting problem or does anyone else in the family have one? ON is basically on a very simplified level like blood clots in the bones. So you have this condition where your blood clotting gets screwed up for whatever reason - chemo, steroids, FVL, etc and the blood supply to the bones is interfered with and then you get bone death (ON) which is experienced as pain. It can happen to some very susceptible people after only one dose of steroids and can occur in one joint or many. Or it can just happen for no apparent reason. Interestingly enough, the local lawyers are advertising for clients on TV who my have gotten ON in the jaw from taking Fosomex. Can't figure that one out. ON can be treated in the early stages with aspirin and vitamins or blood thinners but if it gets to the later stages joint replacement is the only option which is why it is important to get the dx early. I was told that by the time ON of the hip shows up on a regular x-ray it's usually too late to treat it. Early MRI's will catch it in stage one. I was lucky to catch mine in the knee and foot at stage one when I was being looked at for something else and it showed up. After three months on the vitamin aspirin protocol my ON was gone. Check out the writings of Dr. Charles Glueck at the Jewish Hospital in Cincinnati. He was very helpful in helping me get the right dx. and worked with my local dr here in Florida. http://www.jewishhospitalcincinnati.com/cholesterol/osteonec.htm I have an article call Osteonecrosis 101 I can email you if you want. Just let me know. Enjoy your holiday! Cyberhugs, DianeW It is only with the heart that one can see rightly; what is essential is invisible to the eye. --Antoine de Saint Exupéry > Well, taking steroids definitely puts you at a higher risk for ON. > That's what supposedly happened to Bo Jackson from all the steroid [quoted text clipped - 37 lines] > It is only with the heart that one can see rightly; what is essential > is invisible to the eye. --Antoine de Saint Exupéry Some notes about ON from personal experience: since starting anabolic steroids and an anti-osteoporotic bisphosphonate drug, the osteonecrosis in my left wrist has actually started healing. I suspect, given the time frames involved, it was the bisphosphonate drug that has made the difference combined with high long term doses of an iron chelation drug (it was likely massively high iron levels from 300+ transfusions that caused the osteonecrosis in the first place). That said, the anabolic steroids (in moderately high doses) started my dead marrow producing blood cells again. I mention this because there's an experimental treatment whereby cartilage is regenerated by drilling into the marrow cavity of the bone and allowing these 'stem cells' to bleed into the area of damaged cartilage while the joint is immobilised. These marrow cells then regenerate the cartilage. This sounds very much like a sometimes used treatment for osteonecrosis called 'core decompression' which sometimes works. It was supposed to work because it relieved the pressure of the clots within the bone to allow revascularisation. I strongly suspect that this is not the mechanism of action, but rather regeneration from the marrow stem cells into the drill holes through the dead bone. If this idea hasn't been publised already, it soon will be. To all readers: if you decide to use this idea in one of your papers I expect a citation if it has not been previously suggested elsewhere! Regards, Ari Signaturespammage trappage: remove the underscores to reply I'm going to die rather sooner than I'd like. I tried to protect my neighbours from crime, and became the victim of it. Complications in hospital following this resulted in a serious illness. I now need a bone marrow transplant. Many people around the world are waiting for a marrow transplant, too. Please volunteer to be a marrow donor: http://www.abmdr.org.au/ http://www.marrow.org/ >I always thought that RA was a slow-moving degenerative desease, so my >question is - can RA really develop that quickly - from feeling OK one >week to having all sorts of problems the next? That's how it affected me, Jeremy. Suddenly one evening I just hurt all over. But I can't say if this is usual or unusual. You should get lots of comments from folks here. --- Joan >>I always thought that RA was a slow-moving degenerative desease, so my >>question is - can RA really develop that quickly - from feeling OK one [quoted text clipped - 5 lines] > --- > Joan Similarly for me with my lovely new friend spondyloarthropathy...and it did not just stick to the sacroiliac joints! Signaturespammage trappage: remove the underscores to reply I'm going to die rather sooner than I'd like. I tried to protect my neighbours from crime, and became the victim of it. Complications in hospital following this resulted in a serious illness. I now need a bone marrow transplant. Many people around the world are waiting for a marrow transplant, too. Please volunteer to be a marrow donor: http://www.abmdr.org.au/ http://www.marrow.org/ > This is my first post to this newsgroup. I'm a 43 year old male living > in the UK. I've just been to my GP this morning and he has sent me for [quoted text clipped - 6 lines] > free up and I'm OK. I also have some pain in my back and shoulders. > After driving 20 miles or so I have difficulty getting out of the car. Hi Jeremy You might also try posting this to uk.people.support.arthritis. It's a bit quieter than this newsgroup but they're very helpful too Splodge (UK) Jeremy, some of us have OA instead of RA. It can also affect different parts of your body. I've had a hip replacement and a thumb joint replacement. Have OA in my neck back, hands, feet, and sometimes just hurt all over. That is one possibility. You really should see a rheumatologist no matter what your GP says. Be sure he refers you. Gwen > Hi, > [quoted text clipped - 24 lines] > > Jeremy. My onset of RA was rather dramatic. I went to bed one Sunday night just fine and by morning I couldn't roll over or walk! But just as soon as I was referred to a rheumy, I was put on the medication which got the inflammation under control. And today I walk just fine Well mostly. But I will warn you that RA didn't show up in my bloodwork for 1 1/2 years later. But the doctors had a positive id because of their own observations. Good luck! Vickie B. > My onset of RA was rather dramatic. I went to bed one Sunday night > just fine and by morning I couldn't roll over or walk! But just as [quoted text clipped - 7 lines] > > Vickie B. thanks Vickie for the How it was with me Post,,, people put too much stock in the blood test results to begin with. Like you, it is the overall results of the RDs observation that ties down the facts that a person has inflam.arth.... Harv |
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