Medical Forum / Diseases and Disorders / Arthritis / January 2006
Confused about symptoms
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Tracy Friesen - 06 Jan 2006 17:50 GMT Hi everyone,
I have PA and have been on MTX for 2.5 years, and on Enbrel for 1 year.
Before MTX, I had very severe inflammation in my knees, fingers, toes, wrist, shoulder, and more moderate inflammation in my back. Things improved a lot on MTX, and have been fantastic since adding the Enbrel.
Last Nov. I stopped MTX, as my hubby and I are starting to plan for a family. Now I think I'm having a mild flare of sorts, but it's not quite like my earlier experiences. I'm wondering if what's going on is the arthritis or not, and would love to hear any opinions/experiences others have had along these lines.
What's happening now that I've been off MTX for 2.5 months is that, apart from some mild increased morning stiffness, I'm having some other different symptoms. I have a steadily-increasing amount of soreness in certain tendons such as the Achilles tendons and (I think) tendons leading from my shoulders into my back, as well as a few in my hands/arms. Also, I'm having a LOT of muscle weakness, particularly in the arms, but also in the upper legs. I had severe muscle weakness in the legs before, when my knees were swollen up like footballs, but since none of the joints are very hot or swollen I don't know if it is arthritis-related or not.
I'm seeing my RD in a couple of weeks, but just thought I'd ask if anyone here has experienced this type of thing and if it's most likely arthritis-related or not.
Your thoughts/advice would be so appreciated!
Tracy
Charrlygrl1 - 06 Jan 2006 21:35 GMT Hi Tracy, Well, to be honest, my first thought is fibromyalgia. I had some very similiar symptoms soon after being diagnosed with ankylosing spondylitis. With me, I had a small amount of swelling and also pain in my forearms, upper back and neck, achilles tendons and upper calf area. Maybe you could check out a tender points chart at a fibro site, and see if you have any of those. My RD told me that it is not at all unusual to 'get' fibromyalgia not long after an immune arthritis diagnosis. Good luck getting pregnant!!!
Harvey R. Stone - 07 Jan 2006 04:26 GMT > I'm seeing my RD in a couple of weeks, but just thought I'd ask if > anyone here has experienced this type of thing and if it's most likely [quoted text clipped - 3 lines] > > Tracy Hi Tracy,,,, Over they years of reading about people with PA,,,,,, Methx. is one of the medicines to control PA and the P in PA. I can only hope that your RD will let you start again and even go up a little on the amount you take because restarting does not work so good. I have RA and restarted Methx. about 3 times and it never worked as well as it did the first time and then not at all but that is RA and not PA. I know people that take Arava, Methx, and Enbrel and still struggle to keep control. I hope that you keep your RD filled in on how you feel and your changes. I also want to welcome you to ASA and hope to become a full time player in this newsgroup. Harv
Ps not all of our posts are about the hard facts of having arthritis,,,, many times its about the people..
Tracy Friesen - 12 Jan 2006 16:54 GMT > Hi Tracy,,,, Over they years of reading about people with PA,,,,,, > Methx. is one of the medicines to control PA and the P in PA. I > can only hope that your RD will let you start again and even go up a > little on the amount you take because restarting does not work so > good. Hi Harv, thanks for your info! Unfortunately my RD can't re-start my MTX because my husband and I are planning a pregnancy. But I will see him next week and tell him about this, and maybe get on some prednisone or something to help.
> Ps not all of our posts are about the hard facts of having > arthritis,,,, many times its about the people.. Yeah, I've been reading here for a long time and can easily see that you guys are awesome! :-)
Tracy
gail - 07 Jan 2006 08:01 GMT > Hi everyone, > [quoted text clipped - 28 lines] > > Tracy gail - 07 Jan 2006 08:27 GMT Tracy, I am a fellow sufferer of PA - having come down with it in 1992. Your systems read similar to mine in the early years of having PA. I have been on MTX now for 10 years as well as cyclosporin (neoral). MTX by it self gave me little help but combined with Cyclosporin and a change in life style I now have an almost normal life.
I found out that large doses of sugar would aggrevate the situation as well as stress (I have just retired - wow). I get my husband to massage my feet (reflexology) - I don't know if it is in my mind but I think it really does help - the morning after he has done it my feet don't say "don't put me on the ground".
You mentioned your not having hot joints - my joints are no longer swollen or hot but there is still weakness - i.e I can walk and be on my legs for hours but I am not very good at going up or down stairs and I guess this is because I don't exercise my legs the way I should - can't get on a bike, hate swimming and no stairs to climb every day. If you get back pain, try lying on your tummy and pushing up on your elbows. To strethen legs lie on your back and lift legs one at a time slowly, try putting weights on your ankles to make your legs work harder. If you don't use it you will loose it.
I have always wondered what started my PA? I had a lot of stress and glandular fever just prior to my first PA symptons? Please reply if you feel your PA is the result of either of these.
Tracy Friesen - 12 Jan 2006 16:59 GMT > I have always wondered what started my PA? I had a lot of stress and > glandular fever just prior to my first PA symptons? Please reply if > you feel your PA is the result of either of these. Thanks for all of your info and help, Gail. I need to tell my husband about the massages. :-)
Re: what started PA... I didn't have a fever or anything. What happened to me was that I tripped and hurt one of my toes. It swelled up a little but then, in spite of just being a minor injury, the swelling didn't go away. I had it x-rayed in case it was broken, but it wasn't. It just kept getting worse, and then a neighbouring toe started to swell too. Finally my doctor gave up on finding a real cause (helpful guy) and prescribed orthotics and that was it. Eventually I had more swelling in other joints and saw another doctor and told her I thought I had PA I(based on internet research of symptoms). She referred me to an RD, who confirmed it.
I have always felt that my PA was sort of lying dormant in my system, waiting for a weakness to strike. I gave it that opportunity when I hurt my toe. I don't have *any* scientific basis for this belief, but it seems like everyone I've read about who's had PA *has* had some kind of injury or illness immediately before symptoms started. It seems like it just needs a 'foot in the door' and then it goes crazy. :-\
Tracy
gail - 13 Jan 2006 08:14 GMT Hi Tracy, You are the first person I have ever corresponded with who has had PA. I was thinking I was the only person who ever had it (joking). You mentioned your toes were first to come up. Well, I also tripped on a mat at work and thought I had broken my toes, then I over balanced and put my hand down to balance myself, then my wrist came up - it wasn't broken either - To start the saga - it all happened within two weeks - I was a teacher, I had a beautiful 9year girl student murdered, I got glandular fever, and PA. I was teaching in a small village (in Australia) so the murder was taken very hard by every one, and as I was the teacher and important the load of helping every one through it was tough, I got glandular fever and worked even feeling half dead because the community and children needed me - anyway the saying that life starts at 40 was so wrong for me, at least thats what I thought when this darn PA took hold. I kept teaching for the next 13 years, and I don't know how, and retired last year - since then my PA has been not too bad, except when I stress.
My prayers are with you, I do hope that the baby you are wanting happens and that maybe it will be the cure to your PA. Why I say this is because babies can change the way your body works. Your RD will know what is best for you - but be careful of prednisone. Injections are safer.
I am looking forward to knowing what your RD tells you. Gail
gail - 07 Jan 2006 08:40 GMT tracy, Just keep exercising, muscle weekness is part of the PA (my opinion). Hopefully you can stay off drugs until you have a baby. Try staying off sugar (makes mine flare up), and stay stress free.
Nann Bell - 07 Jan 2006 16:38 GMT Hi Tracy,
First of all, best of luck in conceiving! I hope you get a beautiful child and you have a remission during pregnancy.
I, too, have PA and have had it in fairly major, though varying ways for 20 years now. As you may know, PA can affect the tendons as well as the joints. Tendon inflammation is not uncommon and it appears that is hitting you now, unfortunately.
I've also been diagnosed with fibromyalgia, but I have noticed the severity of my fibro coincides with the current activity of my PA. I truly seem to have much more muscle weakness when my PA is flaring. There may be some inter-relationship going on that is not yet understood. I recently had to stop my Enbrel and mtx for a month due to a tenacious virus and everything in my body ached as a result.
Also, PA can present very differently at different times. Originally they thought I had sero-negative RA because my first presentation of the PA was absolutely typical of RA. More recent flares and overall behavior of it all for the past 13 years or so though has been much more typical of PA. So it won't always look the same.
Allof which is to say and support my thinking that this most likely is arthritis related. I hope your RD can help you out with it. Are you taking prednisone right now? I know some women have used that to get them through conceiving and carrying a child, though of course you have to be very careful weaning off of it, even more so with PA than with RA.
Best of luck with it all!
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
Tracy Friesen - 12 Jan 2006 17:06 GMT > First of all, best of luck in conceiving! I hope you get a beautiful > child and you have a remission during pregnancy. Hi Nann! Thank you for the well wishes! I am considered a severe case of PA and so my RD has gotten me involved with a wonderful team of doctors who specialize in pregnancy and rheumatic diseases to see me through the entire conception/pregnancy/delivery process, and I'm really hopeful that it's going to go very well. My husband and I are so anxious to be parents! :-)
> I've also been diagnosed with fibromyalgia, but I have noticed the > severity of my fibro coincides with the current activity of my PA. I > truly seem to have much more muscle weakness when my PA is flaring. > There may be some inter-relationship going on that is not yet > understood. Yes, I think there is. When my symptoms have been at their worst, I've always had muscle weakness along with it. That's why I thought that, even though my joints weren't hot and swollen, the weakness combined with the tendon pain *must* be related to my PA. I'd just never experienced it in quite that way. But it seems the responses I've gotten here support my thinking.
I read a bit about fibromyalgia after getting a couple of replies about that, and think that could be very possible for me as well. I hope not
:-\ but I will definitely ask my RD next week.
> I recently had to stop my Enbrel and mtx for a month due > to a tenacious virus and everything in my body ached as a result. Yikes! :-( I hope you're back on both!
> Are > you taking prednisone right now? I know some women have used that to > get them through conceiving and carrying a child, though of course > you have to be very careful weaning off of it, even more so with PA > than with RA. I'm not on prednisone right now. Ironically I *just* finished weaning off it a couple of months ago (a very difficult process, as you mention); but the team of doctors I mentioned earlier are recommending fairly high doses of pred once I stop my Enbrel (probably next week). They may start me on Plaquenil too, as recent studies show that Plaquenil is not dangerous to the fetus, as originally thought. But we'll see. My RD is not as crazy about Plaquenil as these other doctors are. He is on board with the prednisone though, so at the very least I know I will be starting that again soon.
Thanks again for all of your info and help!
Tracy
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