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Date: 20.11.2012
From: nicola benbow

Subject: Consultant

Hi I am 38 and have been diagnosed RA for 4 years on mxt - i am due to see my consultant tomorrow and dont know what to say. My esr is 29 and i am tired at the moment. He put me on anti depressants so i would sleep (but i do sleep!!!) and i couldnt get on with them so stopped them - but he took me off my anti inflam tablets. Just wondered if anyone has any ideas of what works:)
**Also does anyone have any problems eating certain foods since diagnosed. I struggle with onion and fried food and its a nightmare!!!
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Date: 20.11.2012
From: bsk

Subject: Re: Consultant

hi Nicola, have you tried any other dmards or been considered for anti tnfs (you have to have tried 2 dmards and be assessed to qualify)?

Mtx didn't do much for me and I always had steroid injections to help and low dose steroids. Not great I know. I am on Enbrel at the moment but a low dose and it works to some degree, though still on low dose steroids.
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Date: 20.11.2012
From: nicola benbow

Subject: Re: Consultant

I have been on a new one starting with luf..... could nt get on with it - saw a locum type consultant who was brill she said i had been mis managed and should be able to get injections? if the Luf.... didnt work!! But she was only temporary and we now have this chap who seems to like anti depressants as my dad saw him too as he has polymyalja? and he said the same to him!!! I'm sure each consultant has their own agenda.
He told me to swim 3 days a week and should make time too (i totally agree but i still work a minmum of 3 days a week and have 2 children and a lorry driver husband) - but the consultant chap said he played badminton every night after surgery (great if you have the time and money!!)
I have tried sulfa..... and dichla...... i will ask him tomorrow what else there is.
People dont realise i have RA - I hide it very well and try not to curl up and die - i have a family and a life but thats not that i dont struggle and have had to be selfish and say no to things that i would like to do.
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Date: 20.11.2012
From: bsk

Subject: Re: Consultant

I presume your consultant hasn't got RA? And I expect he has a wife at home who is cooking the dinner and keeping house.....? What a cheek. Maybe you could swim three times a week if your arthritis was controlled better as you would certainly have more energy. Try chucking that back at him next time.

If you have tried 2 dmards you are entitled to ask to be assessed for biologics. I would ask him if that is an option and if he says no, ask why not. The fatigue is because your arthritis is active I think.
Don't let him fob you off. Best of luck and let me know how it goes.
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Date: 21.11.2012
From: Colin

Subject: Re: Consultant

Hi Nicola , your CRP result is a better guide to compare to other people with RA , esr varies from person to person but 29 is high

you should qualify for the biologics & ask him , it could improve your mobility a lot , btw allways found swimming makes my RA worse unless its a hydro pool , just end up very stiff afterwards
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Date: 23.11.2012
From: nicola benbow

Subject: Re: Consultant

According to the "expert" I have no inflammation!!! He has suggested a different anti depressant for my tiredness and sent me to see the nurse. She was amazing - she basically told me that although there may not be mass signs on the outside it doesnt mean that there is no grumbling underneath! She gave me a steroid injection and said that it should help give me a boost. I have the helpline number and she also said if i needed and the injection didnt really help she would have a word with the consultant for me - i suprised myself of how low i felt:( He reeled of weak positive results and showed me the graph of activity and said I have reached a Status Quo?
I hate to be blinded by science i did jump down his throat a bit when he was looking at the results - commemnts are great - explainations are better:)
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Date: 23.11.2012
From: bsk

Subject: Re: Consultant

I find my rheumy nurse much better to talk to than my consultant and even he seems to defer to her! What anti depressants has he put you on? Can't say I've ever known anyone be given them for fatigue - much more likely to be your ra causing that.

I would talk to y.our nurse in future, she sounds much more understanding
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Date: 23.11.2012
From: Gillian

Subject: Re: Consultant

I have been taking norotryptolene for about six months now for tiredness. Its an antidepressant similar to amytryptolene but you dont feel so groggy in the mornings. I have fibromyalgia along with RA. I just take 10mg at bedtime. I am also on Prozac, 40 mg daily. Just very glad I buy a prepayment prescription charge card otherwise it would cost me a fortune!
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Date: 23.11.2012
From: bsk

Subject: Re: Consultant

Both those drugs are given in very, very low doses and not efficacious as anti depressants at that level Gillian. AND they make you tired,so not what you prescribe for fatigue lol!
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Date: 24.11.2012
From: Gillian

Subject: Re: Consultant

I know the prozac is high dose but the nortrptolene is low dose. My fatigue came because I was not sleeping properly because of fibromyalgia. Apparently you dont go to the proper sleep level when asleep. The nortrptolene helps me get to the correct sleep level and have more beneficial sleep if that makes sense!
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Date: 24.11.2012
From: bsk

Subject: Re: Consultant

With RA the fatigue is part of the illness, not just because not sleeping - as Nicola says above.

All I was saying is they don't work as anti D at that level. I understand how they are used, I took them myself for pain for about a year. But they would not be what someone would prescribe for RA fatigue if they were sleeping as far as I am aware.
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