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Date: 10.06.2010
From: Christine.

Subject: Hosp appt today - suspected PA !!

OK I finally got to see a rheumatologist today. She was lovely and put my mind at rest. She is pretty certain it is PA but reading other peoples posts on here I feel I only have it mildly. My whole finger on one had swollen badly, two finger joints on other hand hurt a little and my feet around my toes ache. Worse in mornings. Oh and twinges in one hip. Had xrays and bloods today and waiting on an ultrasound then go back in two months. Told me to continue anti inflammatories.
One question I forgot to ask is if I have caught it early is this the worst it will get if I start taking medication soon. Said she may start me on medication once diagnosis confirmed. Hope everyone is having a good day. Christine.
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Date: 10.06.2010
From: louloubelle

Subject: Re: Hosp appt today - suspected PA !!

Hiya Christine

It seems there's a PA epidemic at the moment!!! Welcome to my club anyway, it's a fairly exclusive one. (I've had PA for 21 years now, since the age of 9)

I think early diagnosis can help prevent the disease from progressing too quickly if the rheumy puts you on some disease modifying drugs fairly soon. It sounds like you've been lucky to get a goodun.

We are given anti inflamatories and pain killers to help with the symptoms only whereas disease modifiers (DMARDs / Disease modifying anti rhematic drugs) work on the cause of the problem which is your immune system.

My rheumy did explain years ago when I was very young what causes the problem so I hope I remember rightly (it's fairly layman but helped me to understand)... People suffering from psoriasis and PA have malfunctioning immune systems. The immune system is like a chain reaction and there is one particular bit of it that isn't working properly and makes the body believe we have damage / infection in an area where there is none (ie the skin or a joint). I think there are two types of disease modifiers, one that lets the bodies immune system go through the whole process but stops the bit that then defends the area (i.e. the skin or the joint) and another that interupts one of the links of the immune system chain. If you are prescribed these types of medication it can stop the production of fluid etc which causes the inflamation and pain. I think it is the inflamation that can make the bones and cartilidge wear down which causes even more pain and possible need for joint replacement although this is really not very common in PA sufferers.

I hope this helps. I may have explained it all wrong but the tall and the short of it is that the sooner the disease modifying treatment starts the longer you can hold off the progression of the disease! Examples of this type of medication are sulfasalazine, methotrexate, cyclosporine, gold injections and quite a few others but my mind's gone blank. If you have not had any success with two or more of these types of meds then they can look at putting you on biologics called "anti-tnf"s which is a really new type of drug (I think less than 10 years old) such as etanercept (enbrel), remicade, humira and infliximab.

It can take a bit to get your head around everything but everyone on here's dead helpful if you need any advice and support.

Lou x
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Date: 10.06.2010
From: Christine.

Subject: Re: Hosp appt today - suspected PA !!

Thanks Loulou that makes a lot of sense actually cos she said something similar. She given me leaflets on sulfasalazine and methotrexate to read up on till confirmed. HATE taking tablets cos so scared I will react badly to them but if it stops this progressing then I will put up with side effects.
I feel so relieved that its not all my mind and that I finally have someone give me a diagnosis. She picked up how bad my feet were - been playing up for a bit but thought it wasn't related - oh well.
Thanks again.
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Date: 10.06.2010
From: Sally

Subject: Re: Hosp appt today - suspected PA !!

Wow Lou! You've explained it better than any rheumatologist. Thanks, very interesting!
Christine, I was really nervous about taking Methotrexate but the thought of my joints getting damaged made me decide to go for it. Side effects are minimal at the moment but I am on a low dose. You have to decide yourself but I went in armed with a list of questions, all of which were answered satisfactorily.
Good luck.
Sally xx
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Date: 10.06.2010
From: Christine.

Subject: Re: Hosp appt today - suspected PA !!

Thanks Sally - yep - I have two months before next appt so gonna see how I go on the anti-inflammatories till then. Not been taking them as regular as I could cos I like a drink!! LOL!!
Gonna rethink my diet (need to lose weight too) and keep up my reiki healings!!
Christine.
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Date: 11.06.2010
From: Maz.aust

Subject: Re: Hosp appt today - suspected PA !!

Hi Christine,

Diet has a lot to do with flaring as well ,, things to watch out for are gluten, dairy, sugar, sweeteners are a no no as well & preservatives as well as nightshade vegetables.

Unlike Sally & Loulou I use Antibiotic Therapy to treat my arthritis & am now asymptomatic.

The best thing you can do is be your own advocate. Read everything you can on not only the disease but all treatment paths availabe so that you can make informed decisions.

Good luck
Maz
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Date: 11.06.2010
From: Christine.

Subject: Re: Hosp appt today - suspected PA !!

Thanks Maz.aust - I had read about that and know that dairy actually clears my psoriasis a lot - so went out shopping today and bought loads of gluten/wheat/dairy products - taste a bit different but not nasty at all. Need to lose some weight too so thinking it may help that also. Not heard of antibiotic therapy though - gonna go look it up.
Thanks
Christine.
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