Hi Jim, chroinc fatigue certainly is a symptom for many people with RA. With
a very high sed rate it does sound like there's something going there that
would warrant visit to a rheumatologist. They know the proper testing to do
to find out what is really going on in those joints.

The only thing I would call the idiot doctor for would be a referral to a
rheumy. Please let us know how you make out.

Kelly C.

Fatigue is an issue with RA, but it could also be fibromyalgia.  You
need to see a Rheumatologist to get a proper diagnosis.  Do you have
morning stiffness?  Stiffness is one of the key diagnostic features
for RA generally it will last more than 1 hour in the morning.  Here
are the diagnostic criteria for RA as defined by the American College
of Rheumatology:

1. Morning stiffness

Morning stiffness in and around the joints, lasting at least 1 hour
before maximal improvement


2. Arthritis of 3 or more joint areas

At least 3 joint areas simultaneously have had soft tissue swelling
or fluid (not bony overgrowth alone) observed by a physician. The 14
possible areas are right or left PIP, MCP, wrist, elbow, knee, ankle,
and MTP joints


3. Arthritis of hand joints

At least 1 area swollen (as defined above) in a wrist, MCP, or PIP
joint


4. Symmetric arthritis

Simultaneous involvement of the same joint areas (as defined in 2) on
both sides of the body (bilateral involvement of PIPs, MCPs, or MTPs
is acceptable without absolute symmetry)


5. Rheumatoid nodules

Subcutaneous nodules, over bony prominences, or extensor surfaces, or
in juxtaarticular regions, observed by a physician


6. Serum rheumatoid factor

Demonstration of abnormal amounts of serum rheumatoid factor by any
method for which the result has been positive in <5% of normal control
subjects


7. Radiographic changes

Radiographic changes typical of rheumatoid arthritis on
posteroanterior hand and wrist radiographs, which must include
erosions or unequivocal bony decalcification localized in or most
marked adjacent to the involved joints (osteoarthritis changes alone
do not qualify)

Here are a couple of sites that might be helpful:
http://www.arthritis.co.za/
http://arthritisinsight.com/

The stiffness and fatigue were two of my biggest issues. If you have
RA it is important to get it treated pronto!  The longer you wait the
harder it is to treat.  They have really good drugs these days but
they are extremely expensive.  My treatments run over $20,000 per
year.  Hope you have good insurance and even better it is not RA.
Good luck and keep us posted on how you are doing. -- MZ




Visit my website:
http://www.mzuschlag.com

fatigue is an symptom with RA, but it must be put together with other
symptoms and the results of testing to make a definite diagnosis.  Fatigue is
present in almost every illness as it is a symptom of a fired-up immune
system.  And an elevated sedrate is symptomatic of inflammation in the body,
but the causes of that can vary widely.  And even joint pain can be
indicative of many different illnesses. You really need a decent doctor to do
a more thorough exam and at least one round of testing.

A rheumatologist is one possibility for your next doctor.  But if you can get
with a better primary care, it'd be a really good idea.  This guy doesn't
sound like he's worth your co-pay.

Jim  wrote:

Fatigue is a symptom all or nearly all of the over 100 forms
of arthritis.   Almost immediately after my diagnosis in 1977,
I was (1) advised to avoid becoming fatigued and (2) given
a weight lifting/carring restriction of 20 pounds - later
reduced to 10 pounds.

UNDERSTANDING ARTHRITIS
ARTHRITIS FOUNATION

"For example, stress contributes to pain, as do fatigue and
depression."   page 60

"Just as you must learn to overcome the physical problems
of pain, fatigue, inflammation and stiff joints, you must actively
learn to understand and then deal with the emotional and
social difficulities they can cause."   page 82

... A racetrack is a place where windows clean people.

Jim,

Sorry to hear about your problems at this time.  My advice to you would be
to go to a doc. and get a referral to a rheumatologist.  Your doctor should
have run other test to rule out things such as RA/Lupus etc.  You won't know
anything until these tests are run.  Good luck and let us know what happens.

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

Yes,,,, you feel tired because your immune system is in overdrive against
your body.

I am reading what many have said and done in this newsgroup.  Please see a
Rheumatologist.

And I

The difference between you and I is that it started for me at the age of 38
and I have a friend that it started at  the age of 68 and it took Remicade
and Methx to control it for him.

Harv