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Medical Forum / Diseases and Disorders / Arthritis / January 2005

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RA v. OA and weight gain

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islands@volcanomail.com - 27 Jan 2005 15:08 GMT
Hi everyone,
I'm posting again hoping someone can explain something to me. How do
you tell the difference between RA and OA? I have different symptoms in
both hands-the middle joint on my left index finger (I'm left handed)is
slightly swollen, incredibly painful and I can't use it for anything.
For a while I couldn't bend it at all. The joint at the base of my
right thumb is larger than my left and the joint aches but is far more
bearable than what is going on with my left hand. I have read that in
RA you have symptoms on both sides, is that correct? I am seeing an
ortho on Monday after being completely dismissed by the rheumatologist.
She told me to take the NSAID she gave me for fibromyalgia which really
doesn't work very well. Plus I can't seem to lose any weight while on
it. Will that get better? I understand that it causes fluid retention
but does that mean I can't lose weight as well?
Thanks for reading this. BTW I'm 42.
Lisa
Smokie Darling (Annie) - 27 Jan 2005 15:27 GMT
isla...@volcanomail.com wrote:
> Hi everyone,
> I'm posting again hoping someone can explain something to me. How do
[quoted text clipped - 12 lines]
> Thanks for reading this. BTW I'm 42.
> Lisa

Hi Lisa,

Well, the best and most accurate way would be to see a rheumatologist.
Which I see you've done, can you get a referral to a different RD?
There isn't much in the way of self diagnosis.  RA is *generally*
bi-lateral, but not always.  Everyone reacts differently, so my RA
probably won't look like yours.  My NSAID isn't working well on my RA
either (anymore).

Are you on Prednisone?  That one was always guaranteed to put weight on
me, and make it nearly impossible to get back off.  I was down to about
800 calories a day when I worked (and swam 3 days a week), and still
didn't lose any weight, in fact I gained 20 pounds.  Didn't lose the
weight until I went off the Pred, and then it was a slow, tedious
process (as is all weight loss, thanks).

Smokie Darling (Annie)
spodosaurus - 27 Jan 2005 16:37 GMT
> Hi everyone,
> I'm posting again hoping someone can explain something to me. How do
[quoted text clipped - 12 lines]
> Thanks for reading this. BTW I'm 42.
> Lisa

Please go and see a different rheumatologist. If you're not getting the
service that should be provided then shop around (remember, they are
being paid to provide this service, they're not just doing it out of the
goodness of their hearts).

In both RA and OA you can have symptoms on both sides. There are other
conditions, too, that could be causing this and should be investigated
(or ruled out).

What have you been doing in an attempt to lose weight? I've lost 27kg
(59 pounds) in the last 16 months through making small dietary and
exercise changes.

Cheers,

Ari

Signature

spammage trappage: replace fishies_ with yahoo

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. To jump to the end
of the story, as a result of this I need a bone marrow transplant. Many
people around the world are waiting for a marrow transplant, too. Please
volunteer to be a marrow donor:
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http://www.marrow.org/

islands@volcanomail.com - 27 Jan 2005 23:46 GMT
The reason I posted here is that I visited 17 doctors in my quest to
find out what was wrong with me several years ago (though the symptoms
were about 6 years in the making.) Including one moron who told me that
there was nothing wrong with me but my attitude and that each morning I
should look in the mirror and chant "I am a healthy, healthy person."
To make a long story short it was an autoimmune thyroid disease and as
a result of the wonderful thyroid support ng I not only became
empowered but found my amazing endo-the best doctor in the world, he's
81 and I say a prayer for him each day. Anyway, I've found patients to
be far more empathetic and able to explain or figure out symptoms than
doctors. I have the feeling that I'm in for another long nightmare of
symptoms, being dismissed by doctors and getting sicker and sicker
until I finally find someone good. Hence, my appearances here. I am on
an NSAID and had lost 38 pounds and maintained it easily for 7 months
until going on the medication. I eat a low cal, low fat diet, walk one
half to one hour per day-depending upon how I feel that particular day-
and do low impact aerobics three times a week. I physically can't do
anymore than that and I can't eat any less or any more healthy than I
am already doing. I don't smoke or drink and I cut out caffeine about
10 years ago. I would like to lose more weight and have continued what
I was doing before and each time I go off the medications I lose the
same three pounds then put them back on as soon as I start again. Any
extra weight doesn't do my knees any good. Unfortunately as my health
insurance costs $500. per month (was turned down for regular and am now
on a state high risk program) plus a $25. copay each time and 20% of
the cost of the visit, lab and x-ray I can't afford to do much doctor
shopping, the initial visits are hideously expensive...
> > Hi everyone,
> > I'm posting again hoping someone can explain something to me. How do
[quoted text clipped - 23 lines]
>
> What have you been doing in an attempt to lose weight? I've lost 27kg

> (59 pounds) in the last 16 months through making small dietary and
> exercise changes.
[quoted text clipped - 13 lines]
> http://www.abmdr.org.au/
> http://www.marrow.org/
spodosaurus - 28 Jan 2005 12:37 GMT
> The reason I posted here is that I visited 17 doctors in my quest to
> find out what was wrong with me several years ago (though the symptoms
> were about 6 years in the making.) Including one moron who told me that
> there was nothing wrong with me but my attitude and that each morning I
> should look in the mirror and chant "I am a healthy, healthy person."

I'll have to watch my language here, but let's just say that that doctor
is probaby going to have someone's footwear clad appendage forcefully
inserted into a body orifice one day if he keeps treating people like that.

> To make a long story short it was an autoimmune thyroid disease and as
> a result of the wonderful thyroid support ng I not only became
[quoted text clipped - 10 lines]
> anymore than that and I can't eat any less or any more healthy than I
> am already doing.

What about adding in some weight training? Which NSAID are you on? A lot
of drugs can really mess metabolism about making weight loss difficult.
Are you on other medication as well? What about for the thyroid problem?
Thyroid problems are notorious for contributing to weight problems.

> I don't smoke or drink and I cut out caffeine about
> 10 years ago. I would like to lose more weight and have continued what
> I was doing before and each time I go off the medications I lose the
> same three pounds then put them back on as soon as I start again.

Three pounds isn't really significant in the long run. Indeed, the body
can fluctuate by that much over the course of a day depending on
hydration levels. As many medications can cause the body to hold a
little extra water, that could be contributing.

> Any
> extra weight doesn't do my knees any good. Unfortunately as my health
> insurance costs $500. per month (was turned down for regular and am now
> on a state high risk program) plus a $25. copay each time and 20% of
> the cost of the visit, lab and x-ray I can't afford to do much doctor
> shopping, the initial visits are hideously expensive...

Yikes. I really think it would be a good idea to keep trying for a good
rheumatologist though. I got lucky and found one early on, and he has
been great. Orthopaedic surgeons tend not to really be so good when it
comes to things that they can't fix by cutting.

>>>Hi everyone,
>>>I'm posting again hoping someone can explain something to me. How
[quoted text clipped - 92 lines]
>>http://www.abmdr.org.au/
>>http://www.marrow.org/

Signature

spammage trappage: replace fishies_ with yahoo

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. To jump to the end
of the story, as a result of this I 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/

debbie m. - 28 Jan 2005 21:48 GMT
Lisa,

Hope you find some answers.  I have fibro and inflammatory arthritis.  I've
been on several different NSIADS as most of us have.  As for the wt gain if
you think it is the med. there are many, many NSIADS you can try.  Tell your
doctor your concerns and see if he will change it for you.

debbie m.
http://www.angelfire.com/ga2/angels1/

> The reason I posted here is that I visited 17 doctors in my quest to
> find out what was wrong with me several years ago (though the symptoms
[quoted text clipped - 85 lines]
> > http://www.abmdr.org.au/
> > http://www.marrow.org/
islands@volcanomail.com - 28 Jan 2005 23:35 GMT
Thank you for the doctor recommendation (and any others appreciated
just in case) and for the ideas and support. Today because the weather
is cold seems to be a worse day for me-the pain/stiffness are worse. I
don't know how you folks in cold climates do it. There must be a
connection between meds and weight gain because when I go off them I
lose the weight but end up back on them because of the pain so I'm in
this cycle. I realize that weight gain is the least of my problems but
for general health reasons and the extra weight being hard on my joints
I really need to lose more and this is just one more frustration.
This is a wonderful group. Thank you all for responding! Stay warm,
Lisa
Nann Bell - 28 Jan 2005 02:25 GMT
You need to see a different rheumatologist.  At the very least an assortment
of lab tests and Xrays should have been done to see what is going on.  There
are several types of inflammatory arthritis and sometimes the lines between
them are blurred.  Did this RD poke at and feel your joints?  Heck mine tend
to find a joint or two that I didn't think were bothering me until the doctor
got hold of them.  And beyond that, an NSAID is not appropriate or adequate
treatment for fibro.  You need a new RD.

What part of the country do you live in?  Someone here might be able
torecommend a good RD, subject of course to the doc being on your insurance.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

islands@volcanomail.com - 28 Jan 2005 03:38 GMT
Well, this is a perfect example of what I'm talking about. That an
NSAID is not a treatement for fm (although to be fair to the doctor I
have a very mild case based on what I've read of others often
debilitating symptoms.)It makes sense of course since it doesn't do
much to help me but according to the rheumatologist that's all that I
can do. Yes, she poked and prodded and did every blood test under the
sun (including one or two brand new ones)and x-rayed my joints but the
x-rays were done last summer before my joints swelled up and from what
I've researched the blood tests can often be normal (although my ANA is
off the charts which may or may not be as a result of my thyroid)This
doctor is considered one of the best around which is why I felt so
depressed. I know from hard experience that if a doctor isn't willing
to listen and work with me (s)he is worthless but I had hoped based on
her reputation that she'd be better. I live in Los Angeles and I have a
PPO so I can go to any doctor that I choose.
> You need to see a different rheumatologist.  At the very least an assortment
> of lab tests and Xrays should have been done to see what is going on.  There
[quoted text clipped - 11 lines]
> remove the Gator cheer to email me
> Simply the thing I am shall make me live --- William Shakespeare
Nann Bell - 28 Jan 2005 14:03 GMT
> doctor is considered one of the best around which is why I felt so
> depressed. I know from hard experience that if a doctor isn't willing
> to listen and work with me (s)he is worthless but I had hoped based on
> her reputation that she'd be better. I live in Los Angeles and I have a
> PPO so I can go to any doctor that I choose.

Many of us have found that the well-known doctors aren't necessarily the best
at dealing with patients.  I'm reposting this with a ping to get the
attention of the LA area folks.  Some of them have RDs they really like.  
Anyone remember which one LadyAndy goes to?

Ah, it took me a while to find my old post on Google but here it is - an RD
in Los Alamitos.  The DH's uncle is a disability attorney and knows something
about docs so this guy must be ok!  Here's one possibility -

I finally spoke to my husband's uncle in the Long Beach area tonight.
The RD his wife sees, and is verry happy with is :

David A Minna MD
4772 Katella Ave Suite 200
Los Alamitos, CA 90720-2600
Phone:         (562) 596-3365

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

firechief - 28 Jan 2005 18:39 GMT
Lisa wrote:

> I am seeing an ortho on Monday after being completely dismissed
> by the rheumatologist.  She told me to take the NSAID she gave
> me for fibromyalgia which really doesn't work very well.

From thr Arthritis Foundation:

  Aspirin and other non-steroidal drugs can relieve the pain of the
  disease to some extent but are seldom completely successful.
  It may be necessary to try several in succession before finding
  one that works.  Sleep disturbance which is common may be
  helped by a group of drugs called tricyclic anti-depressants.
  The most widely used one, amitriptyline, is usually given as a
  dose at bedtime.

  Because there is no inflammation, corticosteroids or the long-
  lasting drugs used in RA are of no value.  Doctors sometimes
  inject a muscle-relaxing drug or a local anesthetic directly into
  a painful area to bring about muscle relaxation more quickly.
 
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