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#473835 - 07/22/12 03:40 PM I think I know its PsA. How to make a doc agree?
gilth Offline
Fourth_Degree_AS_Kicker

Registered: 06/19/11
Posts: 323
It took me a while to come to terms with, but I am thinking the probability of my problems being down to psoriatic arthritis are very big.

Shortly summed up, I have pains in anything linked to the spine, so that includes

IS-joints

hips (stiffness is worst, the pain I can live with)

lower spine (real bad at times, but I do have a large disc prolapse there, and that only seems to kick in when I get stiffness and pain from the joints, and then I get sciatic pains and numbness also)

midspine (that has been my best area so far actually)

neck

top of neck (very bad)

additionally I have severe pains in the jaw. Those affect my ears/balance too when at their worst.



I always noticed being worse when stressed (wich is a bit kinky, since I literally thrive and feel a rush under stress. I love it! tongue4 ) That seems to go along with the psoriatic family, as I understand.

The other problem with me not getting a diagnosis can very very easily be explained with PsA as well. No blood tests show arthritis:
No, they wouldnt, would they? The criteria for PsA clearly states negative for the AS gene marker, and no rheumatic factor. Actually only slightly raised CRP, and is some cases anemia will usually show up.

Visual signs: well, if it hits your fingers or toes, or swells up a knee or elbow it would be easy to spot something going on. When it hits joints in the spine, and the jaw?
-Not so easy to tell then, is it? If I had huge and visual psoriasis it would have been picked up on by the rheumy I saw, or the GP, but neither them or me knew I had it until the skin doc diagnosed it.

Too low Vitamin D levels, could they have given anyone a clue?
-Well....maybe, if I had a sharp GP he would look into it to see if anything else was going on, like anemia. But when he is clueless and still convinced anxiety is my only problem, he just wasnt going to order that tested, now was he?

So here I am. still undiagnosed. But I am quite certain I hit the marker at last.

So how do I go about getting the diagnosis then? -It matters as in my country the healthcare is actually quite good AND free of charge, including free phsyical therapy, free medicines and free treatment trips to warmer countries, if you have it severely and actually get to a diagnosis.


So how to make them discover what is so hard to discover?


Well, I have a plan.

I am going to ask to be tested for anemia. I have no clue if I have it, but due to fatigue, and lately noticing how I will not run out of breath in stairs and uphills, but actually feel like I get acid legs from it. like I just dont have the power needed....well it seems prudent I should have that checked. It being a diagnostic criteria too wont hurt if it should turn out I am. I am actually going to tell them why I want that checked, and that I would like that and CRP checked with specific values and in regard to psoriatic arthritis with a small series of tests with some weeks between.

I will also be asking for MRI of my complete spine, including neck, and the jaw as well. I need anything visual that can show swelling, inflammation, degeneration or damage due to arhtritis for a diagnosis. It is VERY improtant I get it done in any case, as I have had a lot of neuropathy and nerve involvement the last half year. PsA can actually lead to dislocations in the neck, and I want answers to why my nerve system is involved.

And I will be asking for a new referral to a rheumy. Last time I saw one they did not know because I did not know that I had Psoriasis.

The last problem has me a little more troubled as to how I deal with though. I have had a lot of stomach problems. They got tons worse after I tried Voltaren for 6 weeks, but thats now almost half a year ago, and I still have problems. diarrhea on and off, acid, heart burn etc. I got a great tip from my homeopath; 1 teaspoon of Natron powder in a galss of water every day. It helps a lot. But it still feels like stuff is not passing as easily through as it should, up to the point that 3 or 4 times I have actually got some sort of spasm inside my stomach on the left side, almost behind the lowest rib. It feels like something big suddenly moves through a very narrow hose. yeah yeah, I know it sounds weird, but it actually does. The fist time I actually thought my heart had a huge spasm, imagine that! And I have had a colonoscopy, so it's not the Colon. must be the small intestine I suppose? I will take it up with the docs too, because I wonder if it can be related.



So, does my plan sound reasonable? anyone with a working knowledge of PsA that has any other hints as to get this moster to be visual to a doctor: please tip!


Love
gilth
_________________________
Diagnosis:
Psoriasis
Herniated disc L5/S1
Herniated disc C6/C7
bone marrow edema jaw joint
Vitamin D defficiency
Stomach ulcer

Top
#473872 - 07/22/12 09:14 PM Re: I think I know its PsA. How to make a doc agree? [Re: gilth]
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 19052
Loc: Upstate NY
i guess i'm a bit confused. you say you have been dx'ed with psoriasis by the skin doc. but then say you are undx'ed. why can't you just have the skin doc write you the letter to take to your other docs? i'm confused.

as for your GI issues, get a GI doc. mine is fabulous! and not surprised what voltaren did to you; nsaids kill my stomach! but even without them, i have gastritis and IBS which is often kept under the control, largely with my GI doc's help.
_________________________


sue

USpA
LDN/zanaflex/flector
vits C, D. probiotics. fish oil. CoQ, Mg, Ca
pred taper for flares
occasional naproxen / Aleve
chiro
walk
no dairy (casein sensitivity), limited eggs
future: humira, soon I hope

Top
#473886 - 07/23/12 02:20 AM Re: I think I know its PsA. How to make a doc agree? [Re: gilth]
SJLC Offline
Iron_AS_Kicker

Registered: 02/16/10
Posts: 1046
Loc: CA, USA
Gilth, sorry to hear the NSAID damage is still bothering you...
it is important to get the gut healed up because it is a huge center of the immune system, so whichever autoimmune you have, gut inflammation can make it worse -- true for PsA as well as spondylitis. Glutamine powder is also supposed to help in gut healing, and some other mild supplements like licorice root powder.


Top
#473893 - 07/23/12 09:04 AM Re: I think I know its PsA. How to make a doc agree? [Re: Sue22]
gilth Offline
Fourth_Degree_AS_Kicker

Registered: 06/19/11
Posts: 323
Yeah, my bad, I should have been clearer;

I now have a confirmed diagnosis of Psoriasis (the skin disease). The skin doctor has actually sent a letter to confirm this to my GP, he (the skin doctor) thought it was major find in regard to my joint pains. thats now 6 weeks ago or so. I have struggled with the joint pains for going on 2 and a half years, in and out to the GP, and guess what? -He hasnt even bothered to send a letter to acknowledge he has got a letter from the skin doctor about it. Luckily the useless (insert random rude word) has now actually quit as a GP and I am being assigned a new one.

Now when it comes to Psoriatic Arthritis, the joint disease, I have no diagnosis, this is what I think I have (specifically the spondylitis subgroup), but as of yet I have not even talked to any other doctor (or rheumy) than the skin doctor about it yet.

hence this post smile

Yep, I suppose a GI doc might be something I'll have to consider as well.

Love
gilth
_________________________
Diagnosis:
Psoriasis
Herniated disc L5/S1
Herniated disc C6/C7
bone marrow edema jaw joint
Vitamin D defficiency
Stomach ulcer

Top
#473894 - 07/23/12 09:06 AM Re: I think I know its PsA. How to make a doc agree? [Re: SJLC]
gilth Offline
Fourth_Degree_AS_Kicker

Registered: 06/19/11
Posts: 323
yeah I think that might be the way to start some healing. I just wonder though.....each of the few times I have had problems before earlier in my life, my stomach flared up as well. Makes you think this has been there a good while and is truly auto-immune, doesnt it?

Love
gilth
_________________________
Diagnosis:
Psoriasis
Herniated disc L5/S1
Herniated disc C6/C7
bone marrow edema jaw joint
Vitamin D defficiency
Stomach ulcer

Top
#473900 - 07/23/12 09:49 AM Re: I think I know its PsA. How to make a doc agree? [Re: gilth]
cemc Offline
Platinum_AS_Kicker

Registered: 01/25/10
Posts: 1646
Loc: UK
Definitely ask either the skin doc or your new GP to send the psoriasis diagnosis letter to the rheumatologist and also get them to ask the rheumatologist to reassess your "arthritis" with a view to seeing if it PsA.

Top
#473929 - 07/24/12 12:55 AM Re: I think I know its PsA. How to make a doc agree? [Re: cemc]
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 19052
Loc: Upstate NY
Originally Posted By: cemc
Definitely ask either the skin doc or your new GP to send the psoriasis diagnosis letter to the rheumatologist and also get them to ask the rheumatologist to reassess your "arthritis" with a view to seeing if it PsA.


Glith - thanks for clearing that up. makes sense.

And agree with cemc. I'd think now with a dx of psoriasis and the joint pain, it should just be a matter of connecting the dots!

good luck smile
_________________________


sue

USpA
LDN/zanaflex/flector
vits C, D. probiotics. fish oil. CoQ, Mg, Ca
pred taper for flares
occasional naproxen / Aleve
chiro
walk
no dairy (casein sensitivity), limited eggs
future: humira, soon I hope

Top



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