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Medical Forum / Diseases and Disorders / Arthritis / January 2006

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Update on my other RD appt today

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RK - 03 Jan 2006 19:23 GMT
Well I got back from the other RD a bit ago.  Not sure exactly
how to take it either.  I had a new MRI done on 12/29 and she
semily glanced at the results.  She certainly agreed that I had
quite a severe case of arthritis in my back, but would state 100%
it was AS or not.

Now what confuses me is the MRI findings say this:

1. Findings within the sacroiliac joints are most consistent with
chronic degenerative changes.  I do not see any evidence for active
inflammation or effusion.
(I just googled almost all of #1 and everything came up pointing
straight to AS -- so i'm probably loosing my mind)

2. Moderate degenerative disk changes at L4-5

Now... big question here... *could* the reason no inflammation is shown
because
1.) it's only been a month since my last series of steriods in the
SI/Facet joints?
2) I knew what I was in for and downed 1000mg of Naproxen
30mins prior to the MRI?

I goes on to say:
"There is some fatty replacement and sclerosis involving
the sacroiliac joints bilaterally, more pronounced on the left."
(I do have more pain on the left)

"Views of teh lower lumbar spine demonstrate degenerative disk
changes at L4-5 with type 1 endplate changes and a disk bulge with
mild foraminal narrowing" (can anyone explain that one?)

LOL
"The uterus is within normal limits"
(well thank freakin' God! too bad I've no plans for more kids, d'uh)

Now, decent news... she did agree that I needed something different to
combat the pain, she gave me a script for 2 months worth of Enbrel at 50mg
a week to try and come back in 6 weeks to tell her how it's working -- She
also took me off the Naproxen and put me on Celebrex 70mg a day (take
2, 35mg a day)

She also gave me a referal to a neurosurgeon for them to take a look at
the disk problem.

So... anyone have any suggestions.  Of course I walked away totally lost
once again.  Going friday to get the Enbrel filled -- damn sux to have no
dollars after Christmas.. <g>

Thanks Again everyone, you've been a HUGE help..

Reisa
Rosemarie Shiver - 03 Jan 2006 19:41 GMT
  Doesn't sound like AS, Reisa. With AS, the inflammation causes overgrowth
of bone to where it eventually fuses together.

  You've got degenerative disc disease with bones (endplates) not being
smooth any more. I've got both of those thingies. Do you get bone clicking
in the lower back?

  The pressure on yer spine is from disc bulging rather than stenosis. But
there's no effusion ( leaking) of the disc. That's good.

  Taking the Naprosyn 30 min. b4 did diddly squat. You're sooo cute
sometimes, Reisa! LOL

    Ya gots garden variety arthritic spinal changes...yer wearing out, tho'
ya do need the drugs you were given. The next task is to find out, other
than AS, what is the name of the arthritis you have...is it RA or one of the
CTD's? Or is it this:

http://www.spineuniverse.com/displayarticle.php/article1440.html

    At least yer at the exact right place (here at ASA!)  to explore all of
what's going on with yer arthritis. :-) I hope the meds. you're trying work
right for ya from day one. If not, every med. there is has been taken by
someone here at some time; so whatever you'll be given someone here has had
b4. <g>

Hugs from Rosie

Signature

"If you wanna get it done, you gotta fight for yourself." -- Meat Loaf, Bat
Outta Hell II

>
> Well I got back from the other RD a bit ago.  Not sure exactly
[quoted text clipped - 49 lines]
>
> Reisa
RK - 03 Jan 2006 19:58 GMT
|   Doesn't sound like AS, Reisa. With AS, the inflammation causes overgrowth
| of bone to where it eventually fuses together.

Okay, well thats a major relief! Though, doesn't help solve the problem.
Just sends me off looking more. <g>

|   You've got degenerative disc disease with bones (endplates) not being
| smooth any more. I've got both of those thingies. Do you get bone clicking
| in the lower back?

Bone clicking? lol my husband and kid can tell when i'm coming into a room
from a mile away as much as I click according to them.  Yes, and I also have
quite a bit of what I call grinding.

|   The pressure on yer spine is from disc bulging rather than stenosis. But
| there's no effusion ( leaking) of the disc. That's good.

Yeah, thats good.  I did have stenosis, but it was fixed when I had my
surgery
when I was 25.

|   Taking the Naprosyn 30 min. b4 did diddly squat. You're sooo cute
| sometimes, Reisa! LOL

LOL what! I'm serious, lol I cheat on my blood work all the time, I just
take
a long walk for 2 days prior to any blood work, lol comes back all nice and
neat.. didn't before lol always got my a.s chewed! -- I smartened up. <g>

|     Ya gots garden variety arthritic spinal changes...yer wearing out, tho'
| ya do need the drugs you were given. The next task is to find out, other
| than AS, what is the name of the arthritis you have...is it RA or one of the
| CTD's? Or is it this:

Well I don't think the RA is causing my back issues.  whats a CTD?
and wearing out? wtf! i'm 38 and I've had this problem since I was 25... how
the hell can I be worn out at 25!

| http://www.spineuniverse.com/displayarticle.php/article1440.html

Um... just looked at that page.. and a Orthopedist I saw in 2004 said I had
Spondylosis --

|     At least yer at the exact right place (here at ASA!)  to explore all of
| what's going on with yer arthritis. :-) I hope the meds. you're trying work
| right for ya from day one. If not, every med. there is has been taken by
| someone here at some time; so whatever you'll be given someone here has had
| b4. <g>

True.. I'm just looking to end this misery.  It's just too hard to swallow
it's from
wearing out.. I've not done anything to have made me wear out this much at
this
age.  So, this is why I'm so freakin confused.  LOL I don't like to be
confused.

| Hugs from Rosie

Thanks.. and hugs back at ya.

| > Well I got back from the other RD a bit ago.  Not sure exactly
| > how to take it either.  I had a new MRI done on 12/29 and she
[quoted text clipped - 35 lines]
| > combat the pain, she gave me a script for 2 months worth of Enbrel at 50mg
| > a week to try and come back in 6 weeks to tell her how it's working --  
She
| > also took me off the Naproxen and put me on Celebrex 70mg a day (take
| > 2, 35mg a day)
[quoted text clipped - 9 lines]
| >
| > Reisa
Rosemarie Shiver - 03 Jan 2006 20:15 GMT
 Wearing out meaning literal wear and tear, Reisa. Yer just not tearing,
yet. Homo sapiens sapiens was never meant to walk on two feet...our backs
are made for walking on all fours. And we wimmenz wear out spines faster
when we carry bowling balls on the front and then pass them and call them
'infants'.

  Also...kidz have RA, it's called Juvenile Rheumatoid Arthritis, so age
has nothing to do with whether you can be arthritic. Arthritis isn't just
for little ol' ladies anymore.

  Spondylosis is a fancy name for spine osteoarthritis. As for me, I was
born with mechanical defects and have gone on from there to the the
development of CTD: Connective Tissue Disorder. My spine won't stay put
because the ligaments and tendons are genetically defective from
Ehlers-Danlos ( that's prolly not true of you) and the ligaments and tendons
are chronically inflammed from auto-immune assault. That's whut CTD does.

  I was disabled at age 35 by all of this and and still here and typing at
age 48...so look at all you have to look forward to! <duckin' and gimpin'>
Took me years to find out 'zactly whut was whut as the good folks here can
attest to. Hope it goes faster at finding out what works for you, ya sweet
young thang ya. :-)

More Hugs from Rosie

Signature

"If you wanna get it done, you gotta fight for yourself." -- Meat Loaf, Bat
Outta Hell II

> |   Doesn't sound like AS, Reisa. With AS, the inflammation causes
> overgrowth
[quoted text clipped - 120 lines]
> | >
> | > Reisa
Donald Whitely - 04 Jan 2006 00:13 GMT
 Reisa,

You need to make that appointment with the neurosurgeon and keep it
also.  These are the Doctors who need to look at your back and determine
if some type of remedial action needs to be taken.

Don Whitely

> Well I got back from the other RD a bit ago.  Not sure exactly
> how to take it either.  I had a new MRI done on 12/29 and she
[quoted text clipped - 48 lines]
>
> Reisa
RK - 04 Jan 2006 00:17 GMT
|  Reisa,
|
[quoted text clipped - 3 lines]
|
| Don Whitely

Thank Don, yep I know, i'm sure as much as anyone, i'm tired of
the doctors.  I did call the neurosurgeon and they needed a referal
called back to the RD, they sent one over and made the appt for me,
I was napping when they called to tell me and I can't make out what
she said on the VM so I'll call back in the morning to get the info.

I also found out my insurance will cover the Enbrel, so that's a go also.

Reisa

| > Well I got back from the other RD a bit ago.  Not sure exactly
| > how to take it either.  I had a new MRI done on 12/29 and she
[quoted text clipped - 35 lines]
| > combat the pain, she gave me a script for 2 months worth of Enbrel at 50mg
| > a week to try and come back in 6 weeks to tell her how it's working --  
She
| > also took me off the Naproxen and put me on Celebrex 70mg a day (take
| > 2, 35mg a day)
[quoted text clipped - 9 lines]
| >
| > Reisa
Harvey R. Stone - 04 Jan 2006 00:35 GMT
>  Reisa,
>
[quoted text clipped - 3 lines]
>
> Don Whitely

Good advice.....  RK,,,, have you been in car wrecks,,, wrecks on a
bicycle,,,,, lift heavy objects  //"?   Or as said before,,,, do you like to
bowl?    My mother messed up her back when she was 48 lifting a bowling ball
that she dropped to the floor by mistake.  Almost 20 years later of pain she
had it operated on and she loved the results and lived until she was 86.
Harv
RK - 04 Jan 2006 02:33 GMT
| >  Reisa,
| >
[quoted text clipped - 10 lines]
| had it operated on and she loved the results and lived until she was 86.
| Harv

Um.. well you'd have to bring that up huh Harv?

Let's see, if my poor old mind recalls correctly, I'll give ya the quickest
run down
I can.

At 11, I wreaked on my bike, shoved my knee caps upward into my thighs,
passed
out from the pain as I didn't hit my head, but it knocked me out.  (was
doing a wheely
down the street -- good 1/2 block, jumped the curb instead of using my
driveway
and jarred the front tire loose and it fell off in mid-jump, came down on
the front forks.)

At 16, (yes very stupid I was) I was getting off the freeway and there was
no speed
sign to tell me it was a 45degree turn and was to be at 25mph, it was
raining, I took
it at 40mph and I skid into the left guard rail, bounced off of it, smacked
into the right
curb and back to the guardrail again then jumped the curb and rolled 4x down
into
a ditch... Drove out of the ditch, lol with 2 broken axles on the car --  
trust me had a hell
of a time steering the bugger.. Went to the ER, don't remember what xrays I
had -- said
I was fine and sent home.  I don't even recall being sore the next day.  --  
No seatbelt

At 17, I let a friend drive the pick-up I'd gotten to replace the car that
was totalled in the
previous accident... Me and my cousin were in the bed of the truck... she
took a corner
at 45mph, jumped the curb, rode the curb for 50ft then stopped when we hit a
100yr old
palm tree headon.  I remember flying from back to front a few times.. Only
thing I rem.
hurting was my left elbow, was only bruised, no break from xray.  -- No
seatbelt

At 19, my boyfriend was driving my replacement car and flipped a U-Turn at
that moment
a Dodge Van side-swiped us.  I was 5months pregnant at the time. -- Car was
repaired.
-- No seatbelt

At 20, I was on my way to take one of my midterms, it was raining badly, and
about 200ft
in front of me was a idiot half sticking out of his driveway because he
almost hit his mailbox
I applied the breaks to slow but found I was hydroplaning and speed went
from 35mph to
70mph within a few minutes.. I hit the rear quarter panel of his truck
headon.  -- No seatbelt

At 25, hubby was in military and we were stationed at Hickam AFB, HI ---  
only arrived 43 days
prior and was on our way to make final installment on car insurance there.
On a 5 lane, one way
road, tourist from Utah, decided to make an illegal left in front of us as
we went through the
intersection at 40mph, we hit their drivers rear-quarter panel.  Impact was
on passenger side, I
was the passenger.  -- Yes seatbelt (yes I saw it coming and braced my hands
against the dash --
where the other accidents I was limber and didnt' tense up)

Now, funny thing.. Only time I actually felt pain from any of those was the
last one.  Stenosis was
found on the CatScan taken when I was 25 after the last accident.

And yep, I did bowl for several years, from age 8 - 19 (quit 7th mon preg)
then picked it back up
when I was 29 till 34)  One just cannot quit when they carry a WIBC book
average of 188! <g>
Wasn't my back that stopped me from bowling, I only used a 13lbs ball.. was
the problem with
my thumb and wrist.  I also rarely hurt after bowling unless was in a
tournment and had to bowl
9 games in a day.  And that was only 2x a year.

Okay, so I was a wee bit brutal.. but I honestly don't think I was hurt in
any of those other
accidents except the last one.

Reisa
Rosemarie Shiver - 04 Jan 2006 15:57 GMT
But, but....

   Ya can't have worn down yer spine by age 38 with all of this and a kid,
too? Kids want Momma to pick 'em up...and that's more weight daily than a 13
lb. bowling ball...after we carried them b4 birth. So add that stressor of
yer spine, as well.

  But don't freak out...this kind of lumbar disc prob. is awfully
common...tons and tons of people have it. There's lots of experienced RDs
and neurosurgeons 'cuz this isn't an exotic form of arthritis.

Hugs from Rosie

Signature

"If you wanna get it done, you gotta fight for yourself." -- Meat Loaf, Bat
Outta Hell II

> |
> | >  Reisa,
[quoted text clipped - 45 lines]
> had -- said
> I was fine and sent home.  I don't even recall being sore the next
ay.  --
> No seatbelt
>
[quoted text clipped - 55 lines]
>
> Reisa
Harvey R. Stone - 04 Jan 2006 16:24 GMT
> Okay, so I was a wee bit brutal.. but I honestly don't think I was hurt in
> any of those other
> accidents except the last one.
>
> Reisa

LOLOLOL,   I can only say that have been through a great deal and so has
your spine.   There is no telling what combo of your quick stops did the
damage up and down your spine.    IMO,,, like my mother,,, the damage to
your spine  is not going to heal itself and you are on the right road to
making things better.  I wish you good luck with it all and please keep
coming back to talk about it here.
Harv
Charrlygrl1 - 05 Jan 2006 19:52 GMT
Hi Reisa,
I'm glad that things went ok with the rheumy. The fact that she is
prescribing Enbrel says to me that it is some type of
inflammatory/erosive arthritis. Whether that be RA, AS, CTD or
something else who knows.
From what I've read, and even in my own case, many RDs are reluctant
to call anything AS unless they see the erosions on an MRI or Xray. My
first diag. was erosive poly arthritis or something like that. Second
diag was possible RA. Only after the MRI showed the erosions in my SI
joints did he change it to AS. Having no inflammation in your SI joints
seems to put AS out of the picture. However, I would think that the
steroid shot may have knocked the inflammation back, so that could be
why? I am not a doctor, so I have no clue.
But I can tell you what they told me when all of this first started:
What is most important is treating it, not the name of it. The fact
that they are treating you AGGRESSIVELY is most important. I was on
Enbrel for almost a year before getting an accurate diagnosis.
I felt almost immediate relief from the fatigue that I was dealing
with, but no joint relief for a few months.
I hope that it works well and quickly for you, Reisa...please let us
know,
Char
 
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