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Medical Forum / Diseases and Disorders / Arthritis / January 2006

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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
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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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