Diagnosis: Rhumatoid Arthritis - what to expect?

[bkreigsr]

I've seen some excellent threads here about medical conditions and though I'd tap the board's expertise for my own.
I've been experiencing extreme pain in shoulders, elbows, and wrists, mostly right arm, so for my last annual physical exam my internist ordered the blood work with three extra tests for gout and arthritis. The blood work came back positive for arthritis.
I'm wondering what I should expect in the way of treatment and pain management after I see a rhumatologist next week.
Is there a bunch of further diagnosis I have to go through with MRI's and X-rays, and visits to an orthopedist?
As an aside, I'm have a tendency to take everything the medical community recommends with a grain of salt, (another way of saying I don't trust them?) and currently take no meds.
thanks
Bill K

[Noah930]

Having a good rheumatologist is the most important part of living with this disease. This is something you're going to have for the rest of your life, as far as modern medicine is concerned. It won't kill you, but it may make life more inconvenient. Advances in pharmacological treatment have completely changed the way people live with rheumatoid disease. You may not need to see an orthopedist any time soon.

I think I wrote something on PPOT in the past about this. But basically rheumatoid disease is one of synovial overproliferation. Synovial tissue typically lines joints and tendon sheaths. Those are moving objects, so they need lubrication. Synovial tissue is thin (think tissue paper) and secretes fluid (synovial fluid) which helps lubricate joints and tendons. In rheumatoid disease, the synovial tissue becomes overactivated. It oversecretes. The tissue itself become thickened and boggy, so you may see swelling. It may cause aches and pains. As time progresses, if the swelling is in a joint it may cause erosion of the cartilage there and stretch out the joint capsule (that maintains some of the structural integrity of the joint). So people get characteristic disfigurement and arthritis of the joints or tendon problems. Note that the arthritis is a secondary part of the disease. It isn't so much you get rheumatoid arthritis. Rather, you get rheumatoid disease that will gradually lead to rheumatoid arthritis.

Again, modern meds (DMARDS--disease modifying anti-rheumatic drugs) have made huge leaps in preventing rheumatoid disease from progressing onto rheumatoid arthritis. Best of luck.

[996 esquire]

I've researched some of this for my own conditions, and most of the web info suggests that you basically become a victim of your own immune system, as it attacks the tissue surrounding the joints. - not sure how this info helps, other than support Noah's point that research with meds is still an ongoing pursuit.
Bob S

[bkreigsr]

thanks Noah -
You just summarized in three paragraphs what many have tried, but failed, to communicate to me in terms that I could understand.
I will search through you prior posts.
Bill K

[gsxrken]

Bill, you might also research whether you have a sensitivity to certain foods. It's not an "allergy" that they can test for, which is easier b/c your body produces a histamine response like hives, rashes, swelling lips etc. But there are folks in the RA community that swear by gluten-free/cassein-free diets. Just like psoriasis or IBS colitis, which are related to the immune system gone haywire, there must be some underlying trigger.
Most people don't subscribe to foods having any impact on anything, as elimination diets are not easy to follow. But they are free to try. YMMV. My sister took her son off soy and egg and his asthma is gone. When he goes back on those foods, he's wheezing in a matter of hours.
Best wishes.

[wdfifteen]

My housemate has had RA for 10 years. She gets insanely expensive remicade infusions every 6 weeks or so to slow the progress of the disease and she takes drugs to counteract some of the effects of remicade. She takes a lot of Ibuprofen for pain because opioids don't seem to help her (thank god). The RA and/or the drugs affect just about every part of her body at one time or another in one way or another. She has pain flares that last days or a week, she requires much more rest than she used to, she gets odd soft tissue swellings that are painful, has developed severe GERD, she is susceptible to infections and has to be very careful not to get sick. The doctors are very concerned about damage to her heart but I'm not sure that is from the drugs or the disease. She has two sizes of shoes, the ones for when she has an RA flare are a size and a half bigger.

[vash]

no info BK..just wanted to chime in and wish you luck.

[NY65912]

Biologics are the new way to treat RA. I have Crohn's and am on Humira.

I would not be surprised if it or another injectable biologic drug was prescribed.

I have a buddy with RA and on Humira as well with great results.

It has changed my life.

[leojoshrun]

Bill, As noah said getting good rheumatologist is very important. DMARDs and NSAIDs and other medication for RA has marked significantly. I suggest to take help from them. Hope you do not have to struggle.

Thanks
Leo

[bkreigsr]

Thanks all - for the well wishes and the advice.
I'm doing Sebring 1/31 - 2/4 with the track car, so I'm hoping that I can hold off on the heavy-duty meds until after the event.
Bill K